心理依赖

心理依赖（英語：），亦称精神依赖，指的是在停药、停止某项活动时因情感产生的依赖导致的戒断症状（如煩躁、失乐、焦慮等）。[1][2][5]心理依赖有时候也被认为是成瘾症状的一部分。[6]然而，有些能够让人产生依赖性的药物并不会让人成瘾，反过来也是如此。[6]成瘾与心理依赖都可通过强化（一种操作制約）来缓和症状，但是这两种各自有不同的强化方式。[1][2] 成瘾是一种对奖励刺激的寻求，可通过正向强化的方式减轻症状。[1][2]心理依赖则通常需要反向强化的方式来解决，需要进行某些能够避免戒断症状的行为才能缓和。[1][2]

-{H|zh-cn:依赖;zh-hk:倚賴;zh-tw:依賴; }-
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「成癮及生理、心理依賴」的相關術語詞彙表[1][2][3][4]
  • 成瘾：腦部失調的情形，特徵是會強迫性的接觸犒赏刺激，不去考慮其帶來的負面結果。
  • 成瘾行为：具有犒赏性及正向增強效應的行為
  • 成瘾药物：具有犒赏性及正向增強效應的藥物
  • 依赖性：之前曾頻繁接觸刺激源（例如藥物攝取），中斷接觸後出現戒斷症狀的情形
  • 药物敏化或逆耐药性：在固定藥物劑量的情形下重複給藥，而相同劑量的藥物效果增強的情形
  • 藥物戒斷：在重複藥物使用後停藥，出現的症狀
  • 生理依赖：出現持續生理戒斷症狀（例如疲勞及震顫性譫妄）的依赖性
  • 心理依赖：出現情緒或是精神戒斷症狀（例如煩躁及失乐）的依赖性
  • 增强刺激：特定類型的刺激，接觸後會增加再接觸此刺激的可能性
  • 犒赏刺激：特定類型的刺激，大腦會認為此刺激是正向的，會想再進行的
  • 敏化作用：重複接受某一刺激後產生的刺激增強性反應
  • 物質使用疾患 ：使用特定物質，而且造成臨床上或是功能上的損傷或是困境的情形
  • 藥物耐受性：重複接受某一藥物後產生的藥物降低性反應

参考文献
  1. Nestler, Eric J.; Malenka, Robert C. . 2nd. New York: McGraw-Hill Medical. 2009: 364–375. ISBN 978-0-07-164119-7. OCLC 273018757.
  2. Nestler, Eric J. . Dialogues in Clinical Neuroscience. 2013-12, 15 (4): 431–443. ISSN 1294-8322. PMC 3898681 可免费查阅. PMID 24459410. doi:10.31887/DCNS.2013.15.4/enestler.
  3. . Icahn School of Medicine. [2021-04-29].
  4. Volkow, Nora D.; Koob, George F.; McLellan, A. Thomas. Longo, Dan L. , 编. . New England Journal of Medicine. 2016-01-28, 374 (4): 363–371. ISSN 0028-4793. PMC 6135257 可免费查阅. PMID 26816013. doi:10.1056/NEJMra1511480 （英语）.
  5. Olsen CM. . Neuropharmacology. December 2011, 61 (7): 1109–1122. PMC 3139704 可免费查阅. PMID 21459101. doi:10.1016/j.neuropharm.2011.03.010.
  6. Malenka RC, Nestler EJ, Hyman SE. . Sydor A, Brown RY (编). 2nd. New York: McGraw-Hill Medical. 2009: 364–368. ISBN 9780071481274. The defining feature of addiction is compulsive, out-of-control drug use, despite negative consequences. ...
    Addictive drugs are both rewarding and reinforcing. ... Familiar pharmacologic terms such as tolerance, dependence, and sensitization are useful in describing some of the time-dependent processes that underlie addiction. ...
    Dependence is defined as an adaptive state that develops in response to repeated drug administration, and is unmasked during withdrawal, which occurs when drug taking stops. Dependence from long-term drug use may have both a somatic component, manifested by physical symptoms, and an emotional–motivation component, manifested by dysphoria. While physical dependence and withdrawal occur with some drugs of abuse (opiates, ethanol), these phenomena are not useful in the diagnosis of addiction because they do not occur with other drugs of abuse (cocaine, amphetamine) and can occur with many drugs that are not abused (propranolol, clonidine).

    The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders (2000), which makes distinctions between drug use, abuse, and substance dependence, is flawed. First, diagnosis of drug use versus abuse can be arbitrary and reflect cultural norms, not medical phenomena. Second, the term substance dependence implies that dependence is the primary pharmacologic phenomenon underlying addiction, which is likely not true, as tolerance, sensitization, and learning and memory also play central roles. It is ironic and unfortunate that the Manual avoids use of the term addiction, which provides the best description of the clinical syndrome.
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