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Drug addiction may be viewed as a form of learning during which strong associations linking actions to drug-seeking are expressed as persistent stimulus–response habits, thereby maintaining a vulnerability to relapse. Disrupting cue–drug memory could be an efficient strategy to reduce the strength of cues in motivating drug-taking behavior. Upon reactivation, these memories undergo a reconsolidation process that can be blocked pharmacologically, providing an opportunity to prevent the powerful control of drug cues on behavior. This conceptually elegant approach still calls for more experimental data. However, an increasing body of evidence suggests that drug taking not only accelerates habit forming, but has long-lasting effects on interactions between memory systems eventually leading to a functional imbalance. The dorsal part of the striatum plays a critical role in habit/procedural learning, whereas the hippocampal memory system encodes relationships between events and their later flexible use. Both humans and rodents studies support the view that the hippocampus and the dorsal striatum interact in either a cooperative or competitive manner during learning, the prefrontal cortex being involved in the selection of an appropriate learning strategy. Chronic drug consumption biases normal interactions between these memory systems. For instance, drug-experienced rodents tend to use preferentially striatum-dependent learning strategies in navigational tasks. These persistent effects seem to occur at cellular, neurophysiological and behavioral levels to promote specific, striatal-dependent forms of learning, to the detriment of spatial/declarative, hippocampal-dependent and more flexible types of memory. Whether cue sensitive and response learners, in contrast to spatial learners, could be prone to drug addiction is an intriguing hypothesis which clearly deserves to be further explored. A loss of flexibility may be uncovered also by imposing changing rules on the subject, such as requiring an attentional shift between different perceptual features of a complex stimulus, as in the attentional set shifting task which was recently adapted to rodents. Working memory is at risk during transition phases, although it remains to be determined whether withdrawal-induced alterations are observed also during protracted abstinence. Drug-induced cognitive biases thus lead to cognitive rigidity which could play a critical, yet overlooked role in different phases of addiction (acquisition, extinction/withdrawal and relapse). They are also likely to preclude the clinical efficiency of treatments. Therefore, the aim of this research topic is to provide an overview of the current work investigating the long-term impact of drug use on learning and memory processes, how multiple memory systems modulate drug-seeking behavior, as well as how drug-induced cognitive biases could contribute to the persistence of addictive behaviors.
Drug addiction may be viewed as a form of learning during which strong associations linking actions to drug-seeking are expressed as persistent stimulus-response habits, thereby maintaining a vulnerability to relapse. Disrupting cue-drug memory could be an efficient strategy to reduce the strength of cues in motivating drug-taking behavior. Upon reactivation, these memories undergo a reconsolidation process that can be blocked pharmacologically, providing an opportunity to prevent the powerful control of drug cues on behavior. This conceptually elegant approach still calls for more experimental data. However, an increasing body of evidence suggests that drug taking not only accelerates habit forming, but has long-lasting effects on interactions between memory systems eventually leading to a functional imbalance. The dorsal part of the striatum plays a critical role in habit/procedural learning, whereas the hippocampal memory system encodes relationships between events and their later flexible use. Both humans and rodents studies support the view that the hippocampus and the dorsal striatum interact in either a cooperative or competitive manner during learning, the prefrontal cortex being involved in the selection of an appropriate learning strategy. Chronic drug consumption biases normal interactions between these memory systems. For instance, drug-experienced rodents tend to use preferentially striatum-dependent learning strategies in navigational tasks. These persistent effects seem to occur at cellular, neurophysiological and behavioral levels to promote specific, striatal-dependent forms of learning, to the detriment of spatial/declarative, hippocampal-dependent and more flexible types of memory. Whether cue sensitive and response learners, in contrast to spatial learners, could be prone to drug addiction is an intriguing hypothesis which clearly deserves to be further explored. A loss of flexibility may be uncovered also by imposing changing rules on the subject, such as requiring an attentional shift between different perceptual features of a complex stimulus, as in the attentional set shifting task which was recently adapted to rodents. Working memory is at risk during transition phases, although it remains to be determined whether withdrawal-induced alterations are observed also during protracted abstinence. Drug-induced cognitive biases thus lead to cognitive rigidity which could play a critical, yet overlooked role in different phases of addiction (acquisition, extinction/withdrawal and relapse). They are also likely to preclude the clinical efficiency of treatments. Therefore, the aim of this research topic is to provide an overview of the current work investigating the long-term impact of drug use on learning and memory processes, how multiple memory systems modulate drug-seeking behavior, as well as how drug-induced cognitive biases could contribute to the persistence of addictive behaviors.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Traditionally, impulsive and compulsive behaviors have been categorized as fundamentally distinct. However, patients often exhibit both of these behaviors. This common comorbidity has sparked renewed interest in the factors contributing to the disorders in which these behaviors are prominent. Impulsivity and Compulsivity applies a provocative spectrum model to this psychopathology. The spectrum model is consistent with a dimensional model for psychopathology and considers the dynamic interaction of biopsychosocial forces in the development of impulsive and compulsive disorders. In this important work on impulsive/compulsive psychopathology, leading researchers and clinicians share their expertise on the phenomenological, biological, psychodynamic, and treatment aspects of these disorders. Differential diagnosis, comorbidity of the impulsive-compulsive spectrum of disorders, and assessment by the seven-factor model of temperament and character are discussed. Chapters are also dedicated to the antianxiety function of impulsivity and compulsivity, defense mechanisms in impulsive disorders versus obsessive-compulsive disorders, and the unique aspects of psychotherapy with impulsive and compulsive patients. Clinical researchers and clinicians will be enlightened by this exceptional work. The information provided is supplemented with clinical vignettes, and the final chapter provides a synthetic summary that offers a unified, dynamic approach to impulsive and compulsive behavior.
This book provides an overview of the state of the art in research on and treatment of gambling disorder. As a behavioral addiction, gambling disorder is of increasing relevance to the field of mental health. Research conducted in the last decade has yielded valuable new insights into the characteristics and etiology of gambling disorder, as well as effective treatment strategies. The different chapters of this book present detailed information on the general concept of addiction as applied to gambling, the clinical characteristics, epidemiology and comorbidities of gambling disorder, as well as typical cognitive distortions found in patients with gambling disorder. In addition, the book includes chapters discussing animal models and the genetic and neurobiological underpinnings of the disorder. Further, it is examining treatment options including pharmacological and psychological intervention methods, as well as innovative new treatment approaches. The book also discusses relevant similarities to and differences with substance-related disorders and other behavioral addictions. Lastly, it examines gambling behavior from a cultural perspective, considers possible prevention strategies and outlines future perspectives in the field.
When does a harmless habit become an addition? Why do only some of us get addicted? What can make recovery possible? The Psychology of Addiction is a fascinating introduction to the psychological issues surrounding addiction and the impact they have on social policy, recovery and an addict’s everyday life. The book focuses on drug and alcohol addiction and tackles topics such as whether drug use always leads to addiction and the importance of social networks to recovery. It also looks at how people can become addicted to activities like gambling, gaming and sex. In a society that still stigmatises addiction The Psychology of Addiction emphasises the importance of compassion, and provides a sensitive insight to anyone with experience of addiction.
The treatment of early psychosis has been bedevilled by an entrenched pessimism, stemming from the asylum era and the Kraepelinian model of schizophrenia. More recently, however, there has been a surge of interest in preventively oriented treatment of patients showing the first signs of psychotic illness, with the realization that these illnesses are frequently highly responsive to early treatment. This is the first text to focus on the potential of early detection of psychosis, and the practicalities of treatment. Based on the pioneering experience and research of a now well-established prevention and intervention centre, and with contributions from international authorities, the book outlines a framework for intervention, reviews the evidence available to guide clinical practice, and describes models of treatment. Incorporating many personal narratives and case histories, it is strong on theory, sensitive on practical issues, and will challenge, inform and guide clinicians.
This manual provides guidance on proven disease prevention strategies and practical behavioral science principles for health workers involved in all levels of planning and operating local and regional health programmes. Issues discussed include: basic disease prevention principles; community health intervention strategies; improving health throughout the life cycle; leading forms of death and disability including brain and behavioural disorders, cardiovascular diseases, strokes and cancers; and successful strategies for behavioural change.