RP4: Cue reactivity in gaming disorder and pornography-use disorder: Behavioral and neural correlates and effects of acute stress

线索反应性和渴求是物质使用障碍和成瘾行为研究中的核心概念。执行功能和决策缺陷也被认为在成瘾行为中起着重要作用。急性压力和成瘾行为之间的联系可能会受到执行功能的调节。游戏障碍已被列入ICD-11，作为一种由成瘾行为引起的障碍。色情使用障碍可能被视为强迫性性行为障碍的一个子组成部分，强迫性性行为障碍已被纳入ICD-11。然而，许多作者认为，控制色情使用的具体问题与成瘾行为之间存在相似之处，这表明色情使用障碍可能被视为互联网使用障碍的亚类型，可与游戏障碍相提并论。对游戏障碍和色情使用障碍的线索反应性和渴求的神经成像研究表明，腹侧纹状体以及与额纹状体环有关的进一步结构都有活动。到目前为止，还没有研究系统地比较游戏障碍和色情使用障碍中线索反应性和渴望的神经和行为相关性。考虑到与色情相关的刺激可能被认为是自然奖励，而与游戏相关的刺激可能被认为是次要的增强剂，解决这种反差是很重要的。本研究旨在探讨1)与色情使用障碍相比，游戏障碍中线索反应性和渴求的行为和神经相关性；2)急性应激对线索反应性和渴求的影响；3)线索反应性与渴求、急性应激以及执行功能和抑制控制措施之间的交互作用。该项目将包括五组(每组52名男性参与者)：1)游戏障碍者，2)危险使用游戏者，3)色情使用障碍者，4)危险使用色情物品者，5)控制组参与者，他们同时使用游戏和色情内容，没有问题。这项研究将包括三个部分。在T1，将进行密集的诊断，包括核心电池的实验和神经心理学任务。在T1的第二部分，参与者将被随机分配到Trier社会压力测试的压力条件下或控制组，并将执行线索反应范式和与成瘾相关的图片的决策任务。在T2，将进行fMRI实验(每组34名参与者)，使用改进的线索反应范式。RP4与RP2、RP3和RP6有很强的联系，RP6也将研究线索反应的各个方面。此外，Rp4和Rp7之间有联系，Rp4和Rp5之间有联系，Rp4和Rp7将解决抑制控制和执行功能，Rp4和Rp5将检查压力对线索反应性的影响。

Cue reactivity and craving are core concepts in research on substance use disorders and addictive behaviors. Deficits in executive functions and decision making have also been considered as playing an important role in addictive behaviors. The association between acute stress and addictive behaviors may be moderated by executive functions. Gaming disorder has been included in the ICD-11 as a disorder due to addictive behaviors. Pornography use disorder may be considered as a subcomponent of compulsive sexual behavior disorder, which has been included in the ICD-11. Many authors, however, rather see parallels between the specific problems in controlling the use of pornography and addictive behaviors, suggesting that pornography use disorder may be considered as subtype of Internet use disorders, comparable to gaming disorder. Neuroimaging studies on cue reactivity and craving in gaming disorder and pornography use disorder have shown activities in the ventral striatum and further structures involved in fronto-striatal loops. To date, there are no studies which systematically examined neural and behavioral correlates of cue reactivity and craving in gaming disorder compared to pornography use disorder. It is important to address this contrast given that pornography-related stimuli may be considered as natural rewards, compared to gaming-related stimuli, which may be considered as secondary reinforcers. This project aims at investigating 1) behavioral and neural correlates of cue reactivity and craving in gaming disorder compared to pornography use disorder, 2) the effects of acute stress on cue reactivity and craving, and 3) interactions between cue reactivity and craving, acute stress, and measures of executive functions and inhibitory control. The project will include five groups (each with 52 male participants): individuals with 1) gaming disorder, 2) risky use of games, 3) pornography use disorder, 4) risky use of pornography, and 5) control participants, who use both games and pornography non-problematically. The study will consist of three parts. At t1, the intensive diagnostics will be conducted including the experimental and neuropsychological tasks of the core battery. In the second part of t1, participants will be randomly assigned to either the stress condition of the Trier Social Stress Test or the control group and will perform a cue reactivity paradigm and a decision-making task with addiction-related pictures. At t2, the fMRI experiment (with 34 participants of each group) with a modified cue reactivity paradigm will be conducted. RP4 is strongly linked to RP2, RP3, and RP6, which will also investigate facets of cue reactivity. Moreover, there are links between RP4 and RP7, which will address inhibitory control and executive functions, and RP4 and RP5, which will examine effects of stress on cue reactivity.