Addiction and dependence glossary[1][2][3]
  • addiction – a biopsychosocial disorder characterized by persistent use of drugs (including alcohol) despite substantial harm and adverse consequences
  • addictive drug – psychoactive substances that with repeated use are associated with significantly higher rates of substance use disorders, due in large part to the drug's effect on brain reward systems
  • dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)
  • drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose
  • drug withdrawal – symptoms that occur upon cessation of repeated drug use
  • physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens)
  • psychological dependence – dependence socially seen as being extremely mild compared to physical dependence (e.g., with enough willpower it could be overcome)
  • reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them
  • rewarding stimuli – stimuli that the brain interprets as intrinsically positive and desirable or as something to approach
  • sensitization – an amplified response to a stimulus resulting from repeated exposure to it
  • substance use disorder – a condition in which the use of substances leads to clinically and functionally significant impairment or distress
  • tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose

An addictive behavior is a behavior, or a stimulus related to a behavior (e.g., sex or food), that is both rewarding and reinforcing, and is associated with the development of an addiction. There are two main forms of addiction: substance use disorders (including alcohol, tobacco, drugs and cannabis) and behavioral addiction (including sex, gambling, eating and shoplifting).[4] The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.[5]

Addiction is classified as a chronic brain disorder by the American Society of Addiction Medicine (ASAM).[5] There are several reasons why people develop an addiction. A predisposition to the addictive qualities of substances may be inherited by some people, making it a genetic circumstance. Another cause for addictions could be the environment. Whether or not someone develops substance use problems can be influenced by their home and neighborhood, as well as the attitudes of their peers, family, and culture on substance use.[5] Another cause of developing an addiction could be related to mental health issues: over 50% of individuals with substance use disorders have experienced mental health issues at some point in their lives. Even moderate substance usage might exacerbate mental health issues in individuals.[5] The other view is from the moral standpoint which regards addictive behavior as an intentional choice was freely made by the addict.[6]

Compulsion vs addiction

Compulsions are the basis of addictions. Reward is one major distinction between compulsion in addicts and compulsion as it is experienced in obsessive-compulsive disorder. An addiction is, by definition, a form of compulsion, and involves operant reinforcement. For example, dopamine is released in the brain's reward system and is a motive for behaviour (i.e. the compulsions in addiction development through positive reinforcement).[7]

There are two main differences between compulsion and addiction. Compulsion is the need and desire to do something or carry out a task repetitively or persistently. Whereas addiction is defined by the following step after compulsion where an individual takes action on a compulsion to feel pleasure and satisfaction (the action is known as compulsive behavior). Notably, for addicts, compulsive behavior can lead to “persistent changes in the brain structures and functions” which creates a cycle of motivation for their behavior that is absent in OCD.[6]

Compulsions (and compulsive behavior) do not necessarily include pleasure for the individual but addictive behavior does. In contrast, someone who experiences a compulsion as part of obsessive-compulsive disorder may not perceive anything rewarding from acting on the compulsion. Often, it is a way of dealing with the obsessive part of the disorder, resulting in a feeling of relief (i.e., compulsions may also arise through negative reinforcement).[8]

Correlation between different personality traits and addictive behaviors online

For over a decade, scientists have emphasized that contact with digital technology can potentially lead to addiction. People of all ages utilize digital devices, and their numbers are growing annually. Accordingly, excessive internet use can result in unhealthy internet use, also known as internet addiction.[9]

It's been proven that the big five personality traits and internet addiction are associated. A recent study aimed to examine the relationships between the big five personality traits and internet addiction within this framework.[10] As such, the researchers employed the meta-analysis method. In accordance with the study's goal, twelve papers were included in the meta-analysis, and thirteen effect sizes were derived from these investigations.[10] In this case, it was shown that agreeableness, conscientiousness, extraversion, and openness to new experiences were inversely correlated with internet addiction, while neuroticism was positively correlated with it. As a result, it's thought that the big five personality traits play a significant role in the development of an internet addiction.[10]

Another study focuses on neuroticism, which has been frequently proven to be a risk factor for internet addiction. The following categories were used to summarize the concepts related to neuroticism and internet addiction: internalizing problems, externalizing problems, coping style, and other factors.[11] The most significant finding from the study is that, with rare exceptions, internet addiction has been primarily included as an outcome and all other ideas as predictors.[11] Internalizing problems comprise the most consistent subset of the topics in the study. In addition to having a positive correlation, neuroticism and internalizing problems were independent predictors of internet, smartphone, and social media addiction. Regarding externalizing problems—which were often the subject of less research—the same picture became apparent.[11] The review's findings also demonstrated that, similar to neurotic people's difficulties with emotion regulation, the internet provides them with a special setting in which to deal with unpleasant emotions. Furthermore, having poor-quality social relationships increases the risk of developing internet addiction and other digital addictions, particularly in those with high levels of neuroticism.[11]

Development of addictive behaviors in adolescents

Adolescence is a period of time characterized by significant changes of physical, cognitive and emotional nature.[12] Adolescents are discovering their individuality and struggle to balance their independence with peer conformity.[12] During this transitional period, adolescents are therefore vulnerable to developing addictive behaviors.

Drug or alcohol-induced addictive behaviors in adolescents have been linked to models discussing a stronger sensitization of the appetitive response and disrupted inhibitory control.[13] In early adolescence, individuals lack the motivation to control appetitive motivational tendencies.[13] The presence of positive and negative reinforcers seem to increase alcohol consumption, portraying a positive correlation between motives and alcohol consumption.[13] After initiating drinking, there seems to be an increase in appetitive motivation to drink and a negative effect on controlled regulatory processes.[13] The imbalance between these factors lead to increased substance use.[13]  

In addition to the environmental influences, there seems to be a genetic role in adolescent addictive behaviors. Addiction risk alleles can increase the risk of addictive behaviors in teens.[14]  Furthermore, the prefrontal cortex, the region responsible for decision making and executive function, is still developing during adolescence.[15] This creates a vulnerability and the initiation of addictive behavior during this developmental stage can thus affect long-term functioning.[15]

Therapy for addictions

Therapy for addictions is not a cure, but a way of managing addictive behaviors.[16] It is a treatment tailored to the specific triggers and root causes affecting each patient (such as trauma, stress, or anxiety),[17] and that "enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives."[16]

Various therapeutic approaches exist to assist individuals in modifying addictive behaviors (i.e.: such as yoga therapy, which can “treat or prevent addiction”),.[18] However, individuals seeking therapy for addictive behaviors may benefit significantly from consulting with a therapist recognized by medical institutions for their expertise in addiction or compulsion.[17]

While medical interventions may be necessary for physical detoxification in certain cases, “addiction therapy or addiction counseling is focused on treating psychological addiction”.[19] For instance, individuals may engage in addictive behaviors to cope with “historical trauma”, necessitating a therapist to use trauma focused cognitive behavioral therapy or exposure therapy to address past issues.[19] Alternatively, for those using addictive behaviors to cope with current events, therapy addiction may focus on “learning stress management techniques and emotional regulation skills”, including cognitive behavioral therapy or acceptance and commitment therapy.[19] In other cases, when addiction is intertwined with mental health issues, therapists employ an integrated approach, addressing conditions (i.e.: depression, anxiety, or bipolar disorder) alongside the addiction through procedures such as dialectical behavior therapy or hypnotherapy.[19]

The use of these treatments is increasing in the medical field, as “a shift is occurring to mainstream the delivery of early intervention and treatment services into general health care practice”.[20]

See also

References

  1. Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues in Clinical Neuroscience. 15 (4): 431–443. PMC 3898681. PMID 24459410. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type [nucleus accumbens] neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state.41 ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict.
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    Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.
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