Addiction

Addiction?

aslide9Definitions of Addiction

This is one of the better (if not long winded although there is an even longer version!) definition of addiction –

“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”

Latest Definition of Addiction by the American Society of Addiction Medicine (ASAM)

Another definition on the NIDA website  is “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often self-destructive, behaviors.”

We will address and hope to add to these definitions in this blogsite!

In this blog you will find a comprehensive worldview of what we believe addictive behavior to be in terms of altered neurobiology and in terms of cognitive-affective mechanisms such as stress and emotion dysregulation.

You will also be shown how these models contribute to a comprehensive understanding of  craving and relapse.

If you have any questions or comments please feel free to contact us via the comments section – we would love to hear for you!

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Issues with diagnostic definitions of Addiction:-

These two blogs highlight some of the issues with DSM V definitions of Addiction –

1. Translating  Accurate Diagnosis  into Effective Treatment. 

2. Diagnosis: Towards Validity and Consistency

Now we consider the two main neurobiological theories of addiction before critiquing them and combining them into one comprehensive neurobiological theory of addiction.

We then set out another cognitive-affective theory of addiction to show how this impaired neuro-biology is affected by and affects the stress and emotion dysregulation to initiate, sustain and perpetuate the addiction cycle.

We complete our worldview of addiction in terms of theoretical contributions by providing a theory of craving and relapse using these models.

We believe all one needs to know about the manifestation of addictive beahviour can be found in these three theoretical, but interacting, models of addiction.

We will also link to blogs with highlight the inherent commonalities in all addictive behaviours.

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Neuroscientific Models of Addiction

A Dopamine Model 

A Critique Of the Dopamine Model

A Stress Based Model

A Critique Of the Stress Model

A Combined Stress and Dopamine Model of Addiction

Plus accompanying,

Neuro-anatomical Theory of Addiction

Diagrams of our Neuro-endocrinological Model of Addiction

Plus

Our Stress-Emotion Dysregulation Model of Addiction 

Part 1

Part 2

Part 3

Related Blogs

A Brief History of Treating Addiction as an Emotional Processing Disorder

Negative urgency mediates relationship between alexithymia and dysregulatedbehaviors

Explaining how negative “negative urgency” can be

Intolerance of uncertainty prompts compulsive decision-making

Decision Making Deficits in Addicts

Lack of emotion differentiation propels negative urgency

The need to act via non recognition of emotional states

Understanding emotional processing deficits in addiction

The predictive value of alexithymia in patients with eating disorders

And

Our Cognitive-Affective Model of Craving and Relapse 

Part 1

Part 2

Part 3

Related blogs

How do recovering alcoholics appraise their alcohol related thoughts? 

Negative repercussions of suppressing automatically occurring thoughts about alcohol

Extent of obsessive thoughts about alcohol related to addiction severity?

 

Also

Our blogs on the commonalities of all addictive behaviours can be found in these blogs.

Commonalities Across Various Addictive Behaviours

 

In this blogsite we will be asking and attempting to give answers to the following questions

1. What is addictive behaviour?

2. How is it defined?

3. What are the neurobiological models of addiction –

dopaminergic positive reinforcement models,

stress based negative reinforcement models

and thirdly a model of addiction which combines both these models – the model we subscribe to in this blog and which we have contributed towards in a comprehensive theoretical review article, outlining our model.

4. Are there are additional factors which need to be included in a theory of addiction?

What are these factors e.g do cognitive-affective mechanisms interact with altered brain neurobiology in the addiction cycle?

Again we believe that cognitive-affective factors such as stress and emotion dysregulation play in intitiating and sustaining additive beahaviour?

Also we have recently submitted a theoretical article which shows how people with addictive beaviours use these behaviours to regulate negative emotions and negative self schemata.

This negative emotion regulation is also linked to altered stress systems in the brain which results in an altered and impaired ability to process emotion, i.e. identify, label and use emotion to guide adaptive decision making.

Instead substance and behavioural addicts seem to engage in distressed based impulsive decision making, recruiting more sub-cortical “flight or fight ” parts of the brain when making decisions rather than prefrontal cortex parts of the brain used in reasoned and evaluative thinking and decision making.

5. Are their underlying similarities in all addictive behaviours? If so, what are these common underlying mechanism?

6. Does environment play a role in the risk of later addictive behaviours?

7. Do genetics play a role in these theories of addiction?

8. Are present definitions and theories of additive behaviour accurate or adequate enough?

9. Our proposal for a re-definition of addictive behaviour?

10.  The two theoretical models to which we subscribe?

 

Decreased Dopamine is seen in all addictive behaviours?

Dopamine_receptors

 

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