Journal of Behavioral Addictions最新文献

Introduction: Problematic pornography use (PPU) affects some individuals, causing distress and impaired functioning, and while psychotherapy is considered a first-line intervention, its efficacy remains understudied and unknown to many therapists. This review aimed to comprehensively synthesize the available evidence on psychotherapy for PPU and related problems (i.e., craving).

Methods: For this meta-analytic systematic review, we conducted a systematic literature search, followed by study selection, coding, and data extraction. We then meta-analyzed the resulting studies using a random-effects model with subgroup analyses, meta-regressions, and risk of bias assessments.

Results: 20 studies with 2,021 participants met the inclusion criteria. Most studies included cognitive behavioral therapy and acceptance and commitment therapy interventions. Participants receiving psychotherapy improved significantly more than controls on PPU, frequency/duration of pornography use, and sexual compulsivity, with large effect sizes, that were small for craving. Within-subject effects were also large and stable at follow-up. In addition, single-case designs meta-analyses showed clinically significant reductions in PPU, craving, and frequency/duration. We identified moderate effects for related depression symptoms. Most subgroup and meta-regression analyses adjusting for treatment and sample characteristics were not significant.

Discussion: These results supports the efficacy of cognitive behavioral therapy and acceptance and commitment therapy in treating PPU and related problems. This has relevant implications for clinical practice (e.g., treating these problems with evidence-based interventions). However, these findings are limited by methodological issues, including the high risk of bias identified. To address these limitations, future research should use more rigorous methods (e.g., randomized controlled trials) and include more diverse groups.

Background and aims: There is growing evidence regarding the overlap between trading behaviors and gambling. However, problematic trading behaviors are often assessed using gambling-related instruments, which may not fully capture the nuances of trading. The present study developed and evaluated the psychometric properties of the Trading Disorder Scale (TDS), grounded in in the research criteria proposed by Guglielmo et al. (2016), based on DSM-5 criteria for gambling disorder and internet gaming disorder.

Methods: A cross-sectional survey was administered to 403 Spanish amateur traders. The TDS was tested for reliability, validity, and factorial structure. Latent class analysis (LCA) was used to identify patterns of disordered trading.

Results: EFA and CFA supported a one-factor solution for the TDS, which showed strong internal consistency (ωu-cat = 0.938, KR-20 = 0.877). The scale showed good concurrent validity with PGSI (r = 0.559) and good convergent validity with trading-related variables. LCA identified three classes: non-disordered trading (72.2%), at-risk trading (17.6%), and disordered trading (10.2%). Individuals in the disordered trading group scored higher on TDS, traded more frequently, monitored markets more intensively, and exhibited higher rates of problem gambling (PGSI≥5), impulsivity, and substance use. Guglielmo's cut-off point (≥5 criteria) effectively differentiated individuals with disordered trading behaviors from those at-risk and those without disordered trading.

Conclusions: The TDS is a reliable and valid instrument for assessing disordered trading among amateur investors. Further research is needed to explore the scale's predictive validity.

Background and aims: Gambling disorder (GD) is a behavioral addiction often co-occurring with various mental health concerns, such as problematic pornography use (PPU). The specific impact of the co-occurrence of GD and PPU on treatment outcome remains underexplored. This study aimed to compare the treatment outcomes of individuals actively receiving treatment for GD (n = 172; 3.49% females), distinguishing between those without PPU (n = 146) and those with co-occurring GD and PPU (n = 26).

Methods: Cognitive-behavioral therapy (CBT) was administered in 16 weekly sessions, with assessments of GD severity, impulsivity, emotion regulation, psychopathology, and personality. Dropout, relapses, number of sessions attended, number of relapses, and amount of money spent during relapses were assessed as the main treatment outcomes.

Results: Patients with co-occurring GD and PPU showed greater GD severity, psychopathology, impulsivity, and difficulties in emotional regulation compared to those with GD and without PPU. Moreover, the presence of PPU appeared to be mainly associated with higher likelihood of treatment dropout, and, consequently, fewer CBT sessions attended.

Discussion and conclusions: It is important to evaluate GD/PPU co-occurrence and strengthen the CBT approach for GD patients with PPU by using supplementary strategies to improve treatment adherence.

Background and aims: Problematic mobile phone use can disrupt social interaction and well-being, potentially influencing cognitive processes. This study investigated whether mobile phone use problem severity is associated with alterations in the topological organization of brain networks.

Methods: Rs-fMRI and DTI data were collected from 81 healthy participants. Graph theory analyses were applied. The Mobile Phone Problem Use Scale-10 (MPPUS-10) was used to assess mobile phone use problem severity. Correlation analyses were conducted between each graph metric and questionnaire scores.

Results: MPPUS-10 scores correlated with global fMRI metrics: higher scores linked to longer shortest path length (reduced integration) and lower global efficiency (reduced information transfer). Conversely, higher MPPUS-10 scores were correlated with a greater clustering coefficient and higher local efficiency, which reflect increased local connectivity. Furthermore, higher MPPUS-10 scores were associated with a higher sigma value from DTI, indicating altered structural network properties. Some specific brain regions also showed significant correlations with MPPUS-10 scores.

Discussion and conclusion: These findings indicate that higher mobile phone use problem severity is associated with decreased integration and increased segregation of functional networks, alongside enhanced small-worldness in structural networks. Reduced integration aligns with addiction theories suggesting digital overload worsens network dysfunction, disrupting brain connectivity. Additionally, higher severity was correlated with altered connectivity in multiple regions, such as the precentral gyrus, supplementary motor area, and postcentral gyrus. These regions are associated with motor control, sensorimotor processing, and memory function. Further research is needed to explore whether these findings reflect shifts in the integration and integrity of brain information-processing modules.

Background and aims: Digital media have become a fundamental aspect of daily life for children and adolescents, influencing cognitive, emotional, and social development. The present work explores the dual nature of digital media use, identifying both positive and negative impacts on well-being and development.

Methods: A comprehensive review of existing literature was conducted to explore the interplay between digital media use and its effects on child and adolescent well-being. The study employs the Digital Media-use Effects (d-MUsE) model to analyze psychological mechanisms and contextual factors mediating these effects.

Results: Functional media use promotes positive mental, physical, and social outcomes, while dysfunctional use is linked to negative psychological consequences, such as increased anxiety, depression, and social isolation. The proposed d-MUsE model highlights the interplay of psychological mechanisms and contextual factors-both proximal and distal-that mediate the effects of digital media on short- and long-term well-being.

Discussion: The present work endeavours to refine our existing comprehension of the intricate interplay of elements and mechanisms underpinning functional and dysfunctional employment of digital media. Prospective research trajectories, which spotlight factors that hitherto remained at the periphery of investigative scrutiny, find discourse in this synthesis.

Background and aims: Despite the inclusion of Compulsive Sexual Behavior Disorder (CSBD) in the ICD-11, there are many open questions on its neuronal pathogenesis, especially regarding the role of the amygdala. In this study, we aimed to further unravel this issue via a parcellation method based on Recurrence Quantification Analysis (RQA).

Methods: The RQA pipeline was applied to resting-state functional magnetic resonance imaging data from 45 heterosexual males with CSBD and 26 Healthy Controls. Each amygdala was divided into two subdivisions in each group. In the CSBD group, the scores of psychological questionnaires were used as covariates in a second-level seed-to-voxel connectivity analysis with the amygdala as a region of interest.

Results: Obtained parcellations revealed bilateral differences in the sizes of dorsomedial (DM) and ventrolateral (VL) amygdala between groups. Mean values of Shannon's Entropy in the left DM and right VL amygdala correlated negatively with depression level, anxiety, and impulsivity, which might represent a vulnerability to CSBD, but only the right VL was implicated in the severity of CSBD symptoms. Multiple correlations between resting-state functional connectivity of the amygdala subdivisions and CSBD severity were observed, especially between the left VL amygdala and several default mode network nodes.

Discussion and conclusions: This is the first attempt to explore the role of the amygdala in CSBD by a parcellation method. Our results suggest the importance of the right VL amygdala in understanding the pathogenesis of the severity of CSBD symptoms, which highlights the rising need to explore the amygdala as a complex structure with diverse functions.

Background and aims: The Interaction of Person-Affect-Cognition-Execution (I-PACE) model of behavioral addictions is used relatively often as a scientific framework to specify research hypotheses and to interpret empirical findings in behavioral addiction research. There are, however, controversial interpretations in the literature regarding some specific elements of the model, which may require a more precise definition of specific constructs and processes that are central to the I-PACE model.

Methods: This is neither a comprehensive literature review nor a proposal for a new version of the I-PACE model. We aim to provide a selective, critical evaluation of some interpretations of the model and to include recent developments regarding addiction theories and controversial debates.

Results: The role of gratification and compensation and therefore positive and negative reinforcement are specified. The concepts of cue-reactivity and craving are considered in the context of desire thinking and permissive beliefs. The relationships between impulsive, habitual, and compulsive behaviors in behavioral addictions are discussed. The effects of general self-control and situation-specific executive functions are elaborated. Punishment (in)sensitivity is discussed as a further important process potentially involved in behavioral addictions. These constructs and processes (through their interactions) are considered in the context of changes over time in the course of addictive behaviors.

Conclusion: This viewpoint article aims to provide greater precision and clarity regarding some specific elements of the I-PACE model, which may help stimulate research and theory building and advance clinical care in the behavioral addiction field.

Behavioral addictions share symptomatological features with substance addiction. From the associative learning perspective, these characteristics include excessive and unregulated self-administration of sensory and other reinforcers, potentially reflecting the transition from goal-directed actions (action → outcome associations) to habitual responses (stimulus → response associations). In laboratory mice, light stimulation at an optimal intensity possesses some incentive properties and a brief light pulse represents an effective reinforcer for persistent operant responding. The operant light self-administration paradigm with clearly defined sensory reinforcers and reinforcement schedules may be utilized to elucidate the general mechanisms of excessive habitual responding to seek non-drug and non-feeding cues in mice. This cross-species approach can shed light on some maladaptive habits that have emerged recently in our modern society, including digital technology-based disorders.

Background and aims: Problematic smartphone use are prevalent worldwide, particularly among adolescents, and it is strongly linked with aggressive behavior. However, the understanding of how PSU may contribute to the emergence of aggressive behavior remains incomplete.

Methods: The purpose of this study was to examine the bidirectional links between aggressive behavior and PSU among adolescents, utilizing data from a two-wave longitudinal study (the time interval is 15 months) conducted among 2,650 students in middle and high school.

Results: The cross-lagged models revealed that: (1) PSU at Time 1 (December 12) positively predicted aggressive behavior at Time 2 (March 2023, 15 months apart) among older adolescents (15-19 years), but this was not the case for younger adolescents (11-14 years); (2) aggressive behavior at Time 1 positively predicted PSU at Time 2 for both younger and older adolescents. Our findings have identified PSU as a risk factor for aggressive behavior among older adolescents, with those perceiving higher PSU may be particularly vulnerable to developing aggressive behavior over time.

Discussion and conclusions: These results not only enhance our understanding of the links between PSU and aggressive behavior but also provide significant theoretical perspectives for developing future prevention strategies and intervention measures to tackle aggressive behavior among adolescents.

Background and aims: Despite a previously reported connection between compulsive sexual behaviors (CSB), such as problematic pornography use, and heightened cue-reactivity, empirical evidence of the alteration of processes responsible for increased salience attribution to erotic cues remains sparse. Drawing on similarities with addiction models, this study explores the neuronal mechanisms of CSB through the use of appetitive conditioning and extinction with erotic and monetary rewards.

Methods: Thirty-two heterosexual males struggling with CSB (age: 28.9 ± 7.1), and 31 healthy matched participants (age: 27.8 ± 5.6) underwent active appetitive conditioning and extinction tasks in fMRI. The effects of conditioning and extinction towards cues of erotic and monetary rewards were measured via self-assessment (valence and arousal rating towards cues), behavior (reaction times), and brain reactivity.

Results: In conditioning, subjective ratings increased, and reaction times were faster for both erotic and monetary cues among participants with CSB, along with altered activity in ventral striatum (vStr), dorsal anterior cingulate cortex (dACC), and anterior orbitofrontal cortex (aOFC). In extinction, self-assessment ratings remained elevated in the CSB group for both cues in a non-reward-specific fashion, accompanied by altered activity of dACC and vStr.

Discussion and conclusions: These findings suggest enhanced incentive salience attribution to conditioned cues, highlighting a generalized motivational and value-related transfer from rewards to the cues in participants with CSB. Additionally, despite the absence of rewards, the persistence of arousal and valence towards cues underscored the maladaptive extinction process. These insights advance the understanding of CSB's neurobiological underpinnings and its relation to addiction frameworks.