Excessive computer game playing: evidence for addiction and aggression?

Computer games have become an ever-increasing part of many adolescents' day-to-day lives. Coupled with this phenomenon, reports of excessive gaming (computer game playing) denominated as "computer/video game addiction" have been discussed in the popular press as well as in recent scientific research. The aim of the present study was the investigation of the addictive potential of gaming as well as the relationship between excessive gaming and aggressive attitudes and behavior. A sample comprising of 7069 gamers answered two questionnaires online. Data revealed that 11.9% of participants (840 gamers) fulfilled diagnostic criteria of addiction concerning their gaming behavior, while there is only weak evidence for the assumption that aggressive behavior is interrelated with excessive gaming in general. Results of this study contribute to the assumption that also playing games without monetary reward meets criteria of addiction. Hence, an addictive potential of gaming should be taken into consideration regarding prevention and intervention.     

Addictions and the Quest to Control the Object

Most patients come into psychoanalytic treatment engaged in some form of repetitive, destructive behavior that is an externalization or projection of their internal struggles. One form of this object relational acting-out is the addictions, be they to alcohol, gambling, drugs, sex, procrastination, or other variations. The patient's experience is a "must do-can't stop" one that leaves them both desperate and relieved. Patients come to us wanting help in refraining from these addictive patterns. Sometimes, they are attending a 12-step program or are in a day treatment recovery program but need additional assistance in remaining free from their addictive behaviors. Others seek out psychoanalytic treatment while still involved in their addiction, but wish to stop the behavior and build a more positive plan for their lives. This paper examines the deeper object relational issues that lie behind the addictive process. The transference is often colored by acting-out, by sadomasochistic dynamics, by projective identification, and by fantasies of persecution and loss. Case material is used to explore these specific problems as well as the patient's general difficulties with paranoid-schizoid and depressive functioning.     

The application of mindfulness-based cognitive interventions in the treatment of co-occurring addictive and mood disorders

This article reviews the theory, clinical application, and empirical findings on mindfulness-based cognitive therapy (MBCT) for mental health and addictive disorders. Expanding upon the research demonstrating the efficacy of cognitive-behavioral therapy (CBT) for addiction, this article develops and explores the rationale for combining mindfulness-based interventions with evidence-based CBTs in treating addictive disorders, with an emphasis on substance use disorders with co-occurring mood disorders. This article proposes that deficits in affect--regulation related to the behavioral and emotional effects of neurobiological changes that occur with long-term substance abuse--pose a unique set of challenges in early recovery. Prolonged use of addictive substances impairs the brain pathways that mediate certain affect regulation functions. These functions involve attention and inhibitory control, the saliency of and response to addictive versus natural reward stimuli, and the ability to detach or maintain perspective in response to strong emotional states. In treating this affective dysregulation, which can contribute to the vulnerability to relapse in the early stages of recovery, the affect-regulation-specific focus of MBCT adds a valuable element to augment CBT for addiction. Summarizing magnetic resonance imaging and positron emission tomography findings on the effects of MBCT and the neurobiology of drug addiction, this article outlines directions for further research on potential benefits of MBCT for the recovering individual. Finally, this article describes a structured protocol, developed at the Mount Sinai School of Medicine in New York City, which combines CBT with mindfulness-based intervention, for the treatment of affect-regulation issues specific to co-occurring addictive and mood disorders.     

亲代孕前成瘾药物暴露对子代行为的影响及其表观遗传机制

孕前成瘾药物暴露不仅危害使用者的身体健康,而且会对子代的生理行为造成影响,近年来研究发现表观遗传机制在其中发挥重要作用。孕前成瘾药物暴露会对子代的成瘾易感性和焦虑样行为造成影响,引起子代的抑郁样行为和认知受损。这些现象可能是成瘾药物通过引起亲代生殖细胞内表观遗传修饰变化所致,其中包括印记基因、神经递质系统、BDNF三个方面的表观遗传修饰变化。此外,未来除了加强以上三个方面基因的研究,也需要增加其他方面基因的研究,以及寻找能预测子代异常行为的表观遗传生物标志物。     

Élaboration du Questionnaire de mesure de l’intensité des conduites addictives (QMICA) : évaluation des addictions et co-addictions avec et sans substances

Referring to studies about addictive behaviors, the objective of this article is to present the validation of a new tool for the assessment of the addictive behaviors with or without substances: the Addictive Intensity Evaluation Questionnaire (AIEQ). Twelve different versions of the AIEQ have been administered to 354 participants in order to assess their addictive behaviors. The study of the factorial structure of the questionnaire and its reliability allow us considering the psychometric qualities of the AIEQ as satisfactory. The results suggest the existence of a continuum between the absence of addiction and the severe forms of addiction. The discussion section proposes a classification based on the severity of the addictive behaviors and applications of the use of the AIEQ.     

Manufacturing multiple meanings of addiction: Time-limited realities

This article explores how clinicians, patients, and addiction as a youthful science manufacture meaning. Explanations of addictive behavior and addictive disease are viewed as constructs, ideologies, or ways of making meaning. This analysis considers the controversy—over whether addiction qualifies as a disease—to be primarily a matter of epistemology and social perception. Since there is no widespread agreement about what isease means in general, it is not possible to determine whether or not addiction is a disease in particular. The discussion also envisions how treatment for addicted clients might be reformulated as a transactional process utilizing the range of relevant theoretical models as time-limited reframes of addictive reality instead of dichotomizing addiction as either a disease or not.The authors extend thanks to Michelle Bowdler, Nancy Costikyan, Blase Gambino, Teri Loughead, Janet Mann, Peter Monius, Arthur Robbins, and Mitchell Young for their helpful assistance, suggestions, and comments on earlier drafts of this article.     

Addictive Behavior and Family Functioning During Adolescence

The purpose of this study was to examine how adolescent and parental perceptions of family system characteristics predict adolescent addictive behavior patterns. The sample consisted of 252 families. Questionnaires included measurements of family functioning using the FACES III instrument and addictive behavior using the Shorter Promis Questionnaire (SPQ). To predict addictive behavior we conducted step-wise regression analyses (forward method), with the dimensions of the four SPQs as dependent variables and individual (age and gender) and family functioning variables as predictors. Results: Data provide support for the proposal that family system characteristics could predict adolescent addictive behavior; despite our taking not only a normative sample, but also non-clinical families into consideration. Data in literature suggest that adolescent addictions increase in families characterized by weak emotional bonds (low cohesion) and the incapacity to change their power structure, role relationships, and relationship rules in response to situational and developmental stress (high adaptability). These findings reinforce the need to continue to explore family functioning and therefore may provide additional protection against adolescent addiction.     

Facing the Music

Abstract

This article outlines how group practitioners can harness creative strategies to assist addicted clients in verbalizing and addressing the losses associated with addictive disorders. This article overviews the implementation of an experiential process that includes a warm up activity, a psychodrama, and utilization of empty chair techniques to address addiction related grief and loss. In addition, these models assist clients to discuss change and healing from the interpersonal devastation of addiction. Finally, the appropriate use and timing of these models are discussed and a case study is included to illustrate these principles in action.     

Embracing darkness: clinical work with adolescents and young adults addicted to sexual enactments

This paper described common themes and transitions in the treatment of adolescents and young adults presenting as addicted to sexual enactments. Central to their experience is a highly addictive reliance on a bad object, which both enables and relies upon sexually perverse enactments. The paper follows the therapeutic process with patients seen in either group or individual long-term psychotherapy. Their experience is understood in the context of theories central to the work at the Portman Clinic relating to perversion and addiction, combined with some ideas from the field of criminology. Patients usually start by noticing their relationship with their compulsive behaviour, moving from a passive stance to a perception of themselves as active agents. They discover moments that are described as ‘pressing a button’, at which they move from passivity to taking perverse action. Those insights lead to a slowing down of the addictive cycle and emergence of phantasies, core complex anxieties and even hopes, all desperately avoided by taking sexualised action. The paper follows a pathway of change and transformation, which when successful enables patients to reduce or cease addictive behaviours by coming in contact with a good object, enabling both emotional pain and the experience of potency and hope.     

Addiction, helplessness, and narcissistic rage

In many cases addictive behavior serves to ward off a sense of helplessness or powerlessness via controlling and regulating one's affective state. Addicts have a vulnerability to feelings of powerlessness, which reflects a specific narcissistic impairment. The drive in addiction to re-establish a sense of power is, correspondingly, impelled by narcissistic rage. This rage gives to addiction some of its distinctive clinical properties. The narcissistic vulnerability in addicts is discussed. Several brief clinical cases are provided, and the view proposed is correlated with other psychoanalytic perspectives.     

药物成瘾诱导相关大脑核团功能和行为改变的DNA甲基化机制

药物成瘾会导致相关神经环路的结构和功能长期改变.大量新的研究证据表明,在DNA序列不变的情况下,药物成瘾可通过影响不同亚型DNA甲基转移酶(DNMTs)的表达,使脑内多个相关核团发生DNA甲基化以及基因表达的改变,进而导致神经元功能的可塑性变化.因此,DNA甲基化被视作导致成瘾行为长期存在的可能机制之一.结合近几年来的重要发现,本文将重点讨论相关脑区的DNA甲基化在成瘾行为发生发展过程中的作用,以及成瘾药物影响DNA甲基化水平的可能机制,并试图提出可深入的研究展望.     

In search of how people change. Applications to addictive behaviors.

How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.     

脑岛在成瘾中的结构和功能异常

脑岛位于大脑外侧裂的深处, 与情绪和内感受等多种心理功能有关。脑岛在成瘾中的结构变化和功能连接异常, 表明了脑岛在成瘾中的作用, 刺激脑岛区域干预成瘾也逐渐成为研究者们关注的领域。未来的研究应该通过对脑岛进行精细分割和多种方法相结合来进一步考察脑岛在成瘾中的具体作用, 并挖掘不同成瘾类型的共性和特性, 以便更好开展基于脑的成瘾干预。     

Voluntary decision-making in addiction: A comprehensive review of existing measurement tools

The notion of voluntariness, notably the inability to refrain from using an addictive substance, is central to addiction. This review examines different constructs measuring voluntariness in the context of drug addiction. We found 117 articles featuring 123 distinct scales for 11 of the 16 constructs initially searched. Self-efficacy was by far the construct with most scales. Most scales were not specifically developed with samples of people with addictions. From a methodological standpoint, current literature jeopardizes the validity of generalizations about how voluntariness functions and is measured in people with and without a drug addiction. From the standpoint of social psychology, the study of voluntariness remains anchored in an individualistic orientation to the study of cognition and behavior, thus calling for greater crosstalk between psychology subspecialties.     

Jeux de hasard et d’argent en ligne : quelles spécificités en matière de réduction des risques ?

Initially conceived as an alternative to abstinence-based approaches, the initial goal of harm-reduction was to reduce the health consequences of drug use. Applied to all addictive behaviors (with or without use), it aims to reduce the individual and social problems generated by addiction without condemning the behavior. Harm-minimisation remained very poor in the gambling field. However, the legalization of online gambling in France and their specific characteristics, update the need to develop this field, which is still a new and relatively uncommon part of harm-reduction. The aim of this article is to draw up an inventory of existing knowledge, whether it has been tested empirically or not, in an ecological environment or in a laboratory situation, as regards tools allowing the player to remain in control of his gambling behavior. A reflection on future research and other possible tools is envisaged.     

物质成瘾及其戒除:基于反转学习的视角

物质成瘾与反转学习损伤密切相关,成瘾者往往不能灵活地适应变化的刺激—结果的联结,这可能进一步加剧成瘾者的物质使用。近年来研究发现,物质成瘾者的反转学习相关的腹外侧前额和背外侧前额等脑区激活异常,这些异常与成瘾者的冲动性和强迫性有关。此外,个体的反转学习能力对其成瘾行为具有一定预测性。今后应增加对不同类型物质成瘾者的反转学习脑机制及物质相关线索对成瘾者反转学习影响的研究,并且进一步探讨成瘾者的冲动性和强迫性对其反转学习的调节及个体反转学习能力对其成瘾行为的预测。     

药物成瘾理论的新进展

成瘾过程伴随着一系列脑机能和心理机能的改变,但对药物滥用如何导致这些改变以及它们如何诱发成瘾却存在着不同的解释。近年来,由于认知心理学和认知神经科学研究技术在该领域的应用,研究者对药物成瘾过程的认知机能及其脑机制获得了新的认识,且基于对负性生活事件及外部压力在维持药物滥用及诱发复吸行为中的作用的测量学研究和动物实验研究而提出的成瘾理论为该领域的研究开辟了新的思路。本文重点评述了药物成瘾的认知加工模型和以压力或负性情绪为核心的相关理论模型及其研究,并提出进一步研究的方向。     

青少年自我概念与网络成瘾的关系:网络消极体验和学校类型的调节效应

本研究从贵州、江苏等十个地区选取4500名四年级以上的小学生和初中生,采用问卷调查的方法,探讨自我概念对网络成瘾倾向的影响及网络消极体验和学校类型的调节作用。结果发现:(1)自我概念对能够负向预测网络成瘾,重点学校学生的网瘾得分高于非重点学校学生;(2)网络消极体验、学校类型都会影响自我概念的作用。结论:重点学校通过自我概念能够稳定预测网瘾,非重点学校则需考虑网络消极体验的影响。在此基础上对青少年网瘾干预及学校环境进行讨论。     

The God‐Shaped Hole: Addictive Disorders and the Search for Perfection

Clients with addictive disorders who have an internalized need for perfection benefit from an integration of spirituality into counseling treatment. This article provides a review of the literature, offers a spiritual approach for working with clients who struggle with addiction and perfectionism, and provides a case study to demonstrate the effectiveness of the integration of spirituality and counseling.     

Addictive buying: causes, processes, and symbolic meanings. Thematic analysis of a buying addict's diary

The aims of this study were twofold. On the one hand, to reach an understanding of, and to illustrate the experience of addictive buying and, on the other, to throw some light on the controversial subject of addicts' personal responsibility for their behavior. With these aims, a thematic analysis of an extensive diary written by a compulsive buyer is presented. Four themes emerge from the analysis: the defining characteristics of addiction to buying that determine the boundary separating it from other forms of impulsive or careless buying; several causal factors; the role that money and material objects play in family relationships and friendships through the symbolic meanings they adopt; and the relationship of personal values with impulsiveness and self-control. In view of the results, the moral model of addiction to buying is discussed, and an explanatory model of the ambivalence that is characteristic of addiction to buying is proposed, based on a personal hierarchy of values.