Journal of Behavioral Addictions最新文献

Background: The introduction of Compulsive Sexual Behavior Disorder (CSBD) into the 11th International Classification of Diseases has raised expectations for better treatment options for CSBD. Furthermore, the treatment demand has increased, particularly for pornography use disorder (PUD), a subtype of CSBD. Presumably due to the easy access to Internet pornography an increasing prevalence of PUD is observed. Consequently, providing tailored and effective treatment is essential.

Methods: This article provides an overview of the manualized short-term PornLoS Treatment Program (Pornografienutzungsstörung effektiv behandeln- Leben ohne Suchtdruck; translation: Treating pornography use disorder effectively - life without craving). The program combines 24 individual and 6 group psychotherapy sessions with an interdisciplinary approach by offering a novel treatment framework. This includes, e.g., a mobile app, establishment of self-help groups, and access to other social services such as couple counseling. The cognitive-behavioral treatment program contains interventions addressing psychoeducation, cue exposure, impulse control, cognitive restructuring, emotional regulation, and relapse management.We here also describe the study protocol of an ongoing four-arm randomized controlled trial. The aim is to test two variants of the PornLoS Treatment Program differing with respect to their treatment goal (abstinence or reduced pornography use) against cognitive-behavioral treatment as usual and against a waitlist control group. The primary outcome is the absence of a PUD diagnosis at the end of therapy. The total target sample size will comprise n = 316 patients with PUD across eight study sites.

Results: The results will be presented at international conferences and published in a scientific peer-reviewed journal.

Background and aims: Gambling activity evolves along a continuum from recreational to Gambling Disorder (GD) and a particular challenge is to identify whether there are some neurophysiological particularities already present in gamblers at an early stage. Our main goal was to determine whether, in the gamblers' population, neural responses generated during uncertain decisions were different depending on problematic gambling risk defined by the Canadian Problem Gambling Index (CPGI). We tested the following hypothesis, that the Problem Gambling group would show a different brain activity related to outcomes processing than people with low risk.

Methods: For this purpose, we established a relatively homogeneous population of Online Poker Players divided into two groups according to the CPGI (Low Risk and Problem Gambling). By means of high-density EEG, we compared the spatio-temporal dynamics generated during the completion of the Iowa Gambling Task.

Results: One specific topographic map was observed between 150-175 ms after a negative outcome for both groups, whereas it was displayed in the win condition only for the Problem Gambling group. We found that the Global Field Power of this map was negatively correlated with participants' adherence to a strategy. Source localization identified Anterior Cingulate Cortex and Temporal regions as generators of this map.

Discussion and conclusions: Reward hypersensitivity EEG responses identified in the early outcome process could constitute a potential biomarker of problematic gambling.

Background and aims: Cognitive control and reward-related abnormalities are centrally implicated in addiction. However, findings from longitudinal studies addressing neurocognitive predictors of addictive behaviors are mixed. Further, little work has been conducted predicting non-substance-related addictive behaviors. Our study aimed to assess predictors of substance and non-substance addictive behaviors in a community sample, systematically evaluating each neurocognitive function's independent influence on addictive behavior.

Methods: Australians (N = 294; 51.7% female; M[SD] age = 24.8[4.7] years) completed online neurocognitive tasks and surveys at baseline and 3-month follow-up. Self-report scales assessed problematic alcohol use, addictive eating (AE), problematic pornography use (PPU), and problematic internet use (PUI) at 3- and 6-month follow-ups. Linear regressions with bootstrapping assessed neurocognitive predictors for each addictive behavior across a 6-month period.

Results: Neurocognition at baseline did not predict AE or PUI severity at 6-month follow-up. Less delay discounting at baseline predicted higher PPU at 6-month follow-up (β = -0.16, p = 0.005). Poorer performance monitoring at baseline predicted higher AE at 3-month follow-up (β = -0.16, p = 0.004), and more reward-related attentional capture at 3-months predicted higher AE at 6-month follow-up (β = 0.14, p = 0.033). Less reward-related attentional capture (β = -0.14, p = 0.003) and less risk-taking under ambiguity (β = -0.11, p = 0.029) at baseline predicted higher PUI at 3-month follow-up. All findings were of small effect size. None of the neurocognitive variables predicted problematic alcohol use.

Discussion and conclusions: We were unable to identify a core set of specific neurocognitive functions that reliably predict multiple addictive behavior types. However, our findings indicate both cognitive control and reward-related functions predict non-substance addictive behaviors in different ways. Findings suggest that there may be partially distinct neurocognitive mechanisms contributing to addiction depending on the specific addictive behavior.

Background: Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive gambling family history means for people with gambling disorder. We sought to understand the clinical impact of having a first-degree relative with gambling disorder in a sample of adults with gambling disorder.

Methods: Data from 455 participants (aged 18-65 years) who had participated in previous pharmacological and psychotherapeutic clinical trials for gambling disorder were pooled in a secondary analysis. Demographic and clinical variables were compared between those who did versus did not have one or more first-degree relative(s) with gambling disorder. Additionally, we examined whether a family history of gambling disorder was associated with treatment outcome.

Results: 223 (49.0%) participants had at least one first-degree family member(s) with gambling disorder. In terms of clinical variables, family history of gambling disorder was significantly associated with being female, having an earlier age of gambling onset, longer duration of untreated gambling illness, a greater likelihood of developing legal problems secondary to gambling, and higher rates of alcohol use disorder in family members. Family history of gambling disorder was also associated with a greater gambling symptom improvement from pharmacotherapy.

Conclusions: These results indicate that gamblers with a first-degree family member with a gambling disorder may have a unique clinical presentation and better response to treatment interventions.

Background and aims: Neurobiological models of addiction posit that addiction manifests through an amplified salience towards addiction-associated stimuli and a diminished responsiveness to non-addiction-related incentives. However, existing research on reward processing in individuals with problematic pornography use (PPU) has primarily been limited to sexual cue reactivity.

Methods: In this event-related potential (ERP) study, we employed a risky decision-making task involving 30 individuals with PPU and 33 healthy controls (HCs) to examine the effects of PPU on non-pornographic (money) reward valuation.

Results: Compared to HCs, individuals with PPU exhibited compromised sensitivity to monetary rewards. Specifically, while the HC group demonstrated a differential response in late positive potential (LPP) amplitude to various expected value (EV) levels, this pattern was absent in the PPU group. This impairment was associated with poorer adaptive decision-making, as evidenced by PPU participants' inability to adjust risk choices based on changes in EV, leading to a propensity for riskier decisions in disadvantageous situations.

Discussion and conclusions: The findings of impaired monetary evaluation in individuals with PPU may potentially explain why they continually pursue pornographic rewards while showing insensitivity to other rewards in daily life. Consequently, treatment development strategies may prioritize improving sensitivity to non-pornographic rewards within this population.

Background: Gaming Disorder was included as an addictive disorder in the latest version of the International Classification of Diseases (ICD-11), published in 2022. The present study aimed to develop a screening tool for Gaming Disorder, the Gaming Disorder Identification Test (GADIT), based on the four ICD-11 diagnostic criteria: impaired control, increasing priority, continued gaming despite harm, and functional impairment.

Method: We reviewed 297 questionnaire items from 48 existing gaming addiction scales and selected 68 items based on content validity. Two datasets were collected: 1) an online panel (N = 803) from Australia, United States, United Kingdom and Canada, split into a development set (N = 589) and a validation dataset (N = 214); and 2) a university sample (N = 408) from Australia. Item response theory and confirmatory factor analyses were conducted to select eight items to form the GADIT. Validity was established by regressing the GADIT against known correlates of Gaming Disorder.

Results: Confirmatory factor analyses of the GADIT showed good model fit (RMSEA=<0.001-0.108; CFI = 0.98-1.00), and internal consistency was excellent (Cronbach's alphas = 0.77-0.92). GADIT scores were strongly associated with the Internet Gaming Disorder Test (IGDT-10), and significantly associated with gaming intensity, eye fatigue, hand pain, wrist pain, back or neck pain, and excessive in-game purchases, in both the validation and the university sample datasets.

Conclusion: The GADIT has strong psychometric properties in two independent samples from four English-speaking countries collected through different channels, and shown validity against existing scales and variables that are associated with Gaming Disorder. A cut-off of 5 is tentatively recommended for screening for Gaming Disorder.

Background and aims: Previous evidence has indicated that problematic social media use (PSMU) is characterized by an attentional bias to social media icons (such as Facebook icons), but not to social webpages (such as Facebook webpages). They suggest that there may be other factors influencing attentional bias like fear of missing out (FoMO). But it remains unclear how FoMO moderates attentional bias in PSMU. This study aims to investigate whether PSMU show attentional bias for stimuli associated with social media, and how FoMO moderates on attentional bias among PSMU through experimental methods.

Methods: Based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, this study explored mechanisms of attentional bias to social media icons (such as WeChat) related to PSMU and further examined the role of FoMO in this relationship. Specifically, attentional bias patterns to social media icons of 62 participants (31 PSMU and 31 control group) were explored during a dot-probe paradigm combined with eye-tracking in Experiment 1, and attentional bias patterns to social media icons of another 61 individuals with PSMU with different FoMO levels was explored during a dot-probe paradigm combined with eye-tracking in Experiment 2.

Results: Results revealed that individuals with PSMU had an attentional bias toward social media icons, demonstrated by attentional maintenance, and such bias such bias was moderated by FoMO negatively, demonstrated by attentional vigilance and maintenance in PSMU/high FoMO.

Conclusion: These results suggest that attentional bias is a common mechanism associated with PSMU, and FoMO is a key factor on the development of PSMU.

Background: While there are calls to restrict the time spent on gaming because it is seen as problematic and potentially leading to gaming disorder (GD), there is conflicting evidence about this issue. We explored the association between the average weekly time spent gaming and reported GD symptoms. Additionally, Latent Profile Analysis was employed to investigate how time spent gaming relates to variables representing psychological distress (PD), such as satisfaction with life, symptoms of depression, and perceived stress.

Methods: Data were collected using surveys with a large sample of highly engaged gamers (N = 14,740; Mage = 24.14 years, SDage = 7.0, 89.3% males).

Results: We observed a positive, close to linear association between time spent gaming and GD symptoms. Groups at risk of GD played for about 42 h (SD = 19) on average, according to the American Psychiatric Association and World Health Organization frameworks. Furthermore, we identified four profiles representing varying levels of PD. Gamers reporting very high levels of PD (4.2% of the sample) played for 33 h per week on average. Remarkably, a substantial percentage of the sample (41.9%) showed no PD despite playing for 26 h per week.

Conclusion: The association between gaming time and PD is complex as even prolonged time spent gaming can be unproblematic for many gamers.

Background and aims: Despite the inclusion of the Compulsive Sexual Behavior Disorder (CSBD) in the 11th edition of the International Classification of Diseases, emotional and cognitive impairments related to CSBD remains unclear. This study aimed to investigate the behavioral and neuronal effects of emotional interference on cognition among CSBD patients.

Methods: Thirty heterosexual males with CSBD and matched healthy controls (HC) were studied with the Emotional Stroop Task using 5 categories of emotionally arousing words (sex-related, positive, fear-related, negative, neutral) during functional magnetic imaging.

Results: At the behavioral level, we found the main effect of the condition: sex-related words evoked a stronger Stroop effect than other conditions. At the neural level, we found a significant group effect. Among CSBD patients processing of sex-related words was related to increased activity in the right putamen, right thalamus, hippocampi, and left pulvinar, when compared to HC. We also found a negative correlation between neuronal activation and time spent on sexual activity during the week preceding study and numerous group differences in brain regions connected to the emotional and motivational processing of sexually explicit material, correlating with CSBD symptoms.

Conclusions: Behavioral results indicate a specific attentional bias toward sex-related stimuli in both groups, while neural data uncovered stronger reactivity to sex-related words in CSBD compared to HC. This reactivity is related to CSBD symptoms and provides evidence for the interference of sex-related stimuli with cognition. Such results are firmly in line with the Incentive Salience Theory and conceptualizing CSBD as a behavioral addiction.

Background: Changes in brain structural connections appear to be important in the pathophysiology of substance use disorders, but their role in behavioral addictions, such as gambling disorder (GD), is unclear. GD also offers a model to study addiction mechanisms without pharmacological confounding factors. Here, we used multimodal MRI data to examine the integrity of white matter connections in individuals with GD. We hypothesized that the affected areas would be in the fronto-striatal-thalamic circuit.

Methods: Twenty individuals with GD (mean age: 64 years, GD duration: 15.7 years) and 40 age- and sex-matched healthy controls (HCs) underwent detailed clinical examinations together with brain 3T MRI scans (T1, T2, FLAIR and DWI). White matter (WM) analysis involved fractional anisotropy and lesion load, while gray matter (GM) analysis included voxel- and surface-based morphometry. These measures were compared between groups, and correlations with GD-related behavioral characteristics were examined.

Results: Individuals with GD showed reduced WM integrity in the left and right frontal parts of the corona radiata and corpus callosum (pFWE < 0.05). WM gambling symptom severity (SOGS score) was negatively associated to WM integrity in these areas within the left hemisphere (p < 0.05). Individuals with GD also exhibited higher WM lesion load in the left anterior corona radiata (pFWE < 0.05). GM volume in the left thalamus and GM thickness in the left orbitofrontal cortex were reduced in the GD group (pFWE < 0.05).

Conclusions: Similar to substance addictions, the fronto-striatal-thalamic circuit is also affected in GD, suggesting that this circuitry may have a crucial role in addictions, independent of pharmacological substances.