Introduction to behavioral addictions.
Introduction to behavioral addictions.
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DOI：
10.3109/00952990.2010.491884
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Gorelick DA
中科院分区：
文献类型：
--
作者：
Grant JE;Potenza MN;Weinstein A;Gorelick DA
除了精神活性物质摄入外，有几种行为会产生短期奖励，尽管知道不良后果，但这种奖励可能会产生持续的行为，即，减少对行为的控制。这些疾病在历史上有几种概念。一种观点认为，这些疾病沿着冲动-强迫性谱系，有些被归类为冲动控制障碍。另一种但不相互排斥的概念化认为这些障碍是非物质或“行为”成瘾。告知关于精神活性物质和行为成瘾之间关系的讨论。方法：我们回顾了说明冲动控制障碍或行为成瘾与物质成瘾之间的相似性和差异的数据。这个主题与即将出版的美国精神病学协会精神疾病诊断和统计手册第五版中这些疾病的最佳分类特别相关。越来越多的证据表明，行为成瘾在许多领域与物质成瘾相似，包括自然史，现象学，耐受性，共病，重叠遗传贡献，神经生物学机制和对治疗的反应，支持DSM-V工作组提出的成瘾和相关疾病的新类别，包括物质使用障碍和非物质成瘾。目前的数据表明，这一组合类别可能适用于病理性赌博和其他一些更好研究的行为成瘾，例如，网络成瘾。目前还没有足够的数据来证明其他行为成瘾的分类。行为成瘾或冲动控制障碍的正确分类对改进预防和治疗策略的发展具有重大意义。
Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or “behavioral” addictions. Inform the discussion on the relationship between psychoactive substance and behavioral addictions. Methods: We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions. Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
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11.3
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