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Using Multivariate Statistics

Motivational Interviewing: Preparing People for Change

The Psychology of Religion and Coping: Theory, Research, Practice

This article reviews scientific advances in the prevention and treatment of substance-use disorder and related developments in public policy. In the past two decades, research has increasingly supported the view that addiction is a disease of the brain. Although the brain disease model of addiction has yielded effective preventive measures, treatment interventions, and public health policies to address substance-use disorders, the underlying concept of substance abuse as a brain disease continues to be questioned, perhaps because the aberrant, impulsive, and compulsive behaviors that are characteristic of addiction have not been clearly tied to neurobiology. Here we review recent advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease. We review findings on the desensitization of reward circuits, which dampens the ability to feel pleasure and the motivation to pursue everyday activities; the increasing strength of conditioned responses and stress reactivity, which results in increased cravings for alcohol and other drugs and negative emotions when these cravings are not sated; and the weakening of the brain regions involved in executive functions such as decision making, inhibitory control, and self-regulation that leads to repeated relapse. We also review the ways in which social environments, developmental stages, and genetics are intimately linked to and influence vulnerability and recovery. We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling) but may also improve our understanding of the fundamental biologic processes involved in voluntary behavioral control. In the United States, 8 to 10% of people 12 years of age or older, or 20 to 22 million people, are addicted to alcohol or other drugs. 1 The abuse of tobacco, alcohol, and illicit drugs in the United States exacts more than $700 billion annually in costs related to crime, lost work productivity, and health care. 2-4 After centuries of efforts to reduce addiction and its related costs by punishing addictive behaviors failed to produce adequate results, recent basic and clinical research has provided clear evidence that addiction might be better considered and treated as an acquired disease of the brain (see Box 1 for definitions of substance-use disorder and addiction). Research guided by the brain disease model of addiction has led to the development of more effective methods of prevention and treatment and to more informed public health policies. Notable examples include the Mental Health Parity and Addiction Equity Act of 2008, which requires medical insurance plans to provide the same coverage for substance-use disorders and other mental illnesses that is provided for other illnesses, 5 and the proposed bipartisan Senate legislation that From the National Institute on Drug Abuse (N.D.V.) and the National Institute of Alcohol Abuse and Alcoholism (G.F.K.) — both in Bethesda, MD; and the Treatment Research Institute, Philadelphia (A.T.M.). Address reprint requests to Dr. Volkow at the National Institute on Drug Abuse, 6001 Executive Bld., Rm. 5274, Bethesda, MD 20892, or at nvolkow@ nida . nih . gov.

Review Article: Neurobiologic Advances from the Brain Disease Model of Addiction

more rapid recovery may take place, but are not prepared to state that they cure patients who would otherwise be unrecoverable. Psychopathic states have been entirely removed from the mental defectives in the classification and dealt with largely on the lines of Professor Henderson's Salmon lectures. A short chapter on war neuroses contains the experiences of Mira in the Spanish War which were somewhat startling to many people who expected a great increase of psychoneuroses among civilians exposed to war conditions. Instead, it was found that the \" fed ups \

Textbook of Psychiatry

Researchers recently have begun using Mechanical Turk (MTurk), an online crowdsourcing platform, to recruit addiction populations. However, whether the data obtained from substance users and gamblers on MTurk are reliable and valid is unknown. Herein, we assessed the internal and retest reliability of and concurrent and convergent validity of data obtained from addiction populations on MTurk. Current drinkers (N = 208), cannabis users (N = 200), and gamblers (N = 200) residing in the United States completed measures of alcohol, cannabis, and gambling severity, psychological constructs (e.g., impulsivity) related to addictions, overt and subtle measures of valid responding, and motivations for completing MTurk studies. Of the original sample, 88-92% of participants who provided informed consent for recontact completed a reassessment 1 week later. The internal consistency of the addiction severity measures ranged from α = .75 to .93. The stability over 1 week ranged from κ = .57 to .70 for categorical classification, and intraclass correlation coefficient (ICC) = .71 to .86 for continuous measures. The addiction measures were significantly correlated with each other and with other constructs related to addictive behaviors. Overall, 80-85% of participants provided valid responses. They reported attending and answering questions honestly, with financial motives being the most frequently endorsed motivation. After invalid responses were excluded, results remained the same for alcohol and gambling, but significant differences emerged for the cannabis sample. The results suggest that the self-report data obtained from alcohol and gambling populations are of high quality, however, caution is warranted with cannabis populations. MTurk shows promise as a recruitment tool for some addictive behaviors. (PsycINFO Database Record

Reliability and validity of data obtained from alcohol, cannabis, and gambling populations on Amazon's Mechanical Turk.

In the current study, we assessed whether undergraduate electronic gaming machine (EGM) gamblers would be more apt to set a time limit and spend less time gambling when asked to consider setting an explicit time limit prior to their gambling session. To this end, participants (N =  43) were randomly assigned to a time limit pop-up condition or control condition, both of which involved gambling on an EGM in a virtual reality (VR) casino. In the time limit pop-up condition, participants were asked (via pop-up message) to consider setting a time limit on play and entering that limit in an available text box prior to commencing play. In the no time limit pop-up condition, participants engaged in play immediately upon accessing the EGM in the VR casino (i.e. they were not exposed to a time limit pop-up message). As predicted, participants who were explicitly asked to consider setting a time limit on their EGM play were significantly more likely to do so and spent less time gambling than those who were not give...

https://www.tandfonline.com/doi/pdf/10.1080/14459795.2014.910244

Limit your time, gamble responsibly: setting a time limit (via pop-up message) on an electronic gaming machine reduces time on device

Social casino games (i.e., free-to-play online gambling games) are enjoyed by millions of players worldwide on a daily basis. Despite being free to play, social casino games share many similarities to traditional casino games. As such, concerns have been raised as to whether social casino games influences the migration to online gambling among people who have not engaged in such activity (see Griffiths in World Online Gambl 9:12–13, 2010). To date, however, no empirical research has assessed this possibility. Thus, the purpose of the present research was to assess the extent to which social casino gamers migrate to online gambling and potential predictors (time spent on social casino games, skill building, enhancement and micro-transactions) of such migration. To this end, social casino gamers who never gambled online (N = 409) completed a questionnaire battery assessing our variables of interest and were re-contacted 6-months later to see if they had engaged in online gambling during the intervening months. Approximately 26 % of social casino gamers reported having migrated to online gambling. Importantly, engagement in micro-transactions was the only unique predictor of migration from social casino gaming to online gambling. The implications for the potential harms associated with social casino gaming are discussed.

https://link.springer.com/content/pdf/10.1007%2Fs10899-014-9511-0.pdf

Do Social Casino Gamers Migrate to Online Gambling? An Assessment of Migration Rate and Potential Predictors.

Behavioral addictions such as gambling, video games, sex, and shopping share many clinical features with substance use addictions including etiology, course, and neurobiology Yet, the treatment of behavioral and substance use addictions tends to be separated However, we argue that a more effective and efficient treatment approach is to conceptualize behavioral and substance use addictions as different expressions of a common underlying disorder and, in treatment, to address the underlying mechanisms common to both To this end, the article presents a developing transdiagnostic treatment model of addictions that targets underlying similarities between behavioral and substance use addictions, called the component model of addiction treatment (CMAT) The CMAT is transdiagnostic in that it can be used in the treatment of both behavioral and substance use addictions It is pragmatic in that it targets component vulnerabilities, which are enduring, yet malleable, individual psychological, cognitive, and neurobiological characteristics that are common to all addictive disorders and have been demonstrated to be modifiable A working model of CMAT is presented, including proposed component vulnerabilities: lack of motivation, urgency, maladaptive expectancies, deficits in self-control, deficits in social support, and compulsivity, as well as their potential intervention possibilities Future directions and potential implications of the CMAT are discussed

Hyoun S. Kim

Papers

Reliability and validity of data obtained from alcohol, cannabis, and gambling populations on Amazon's Mechanical Turk.

Limit your time, gamble responsibly: setting a time limit (via pop-up message) on an electronic gaming machine reduces time on device

Do Social Casino Gamers Migrate to Online Gambling? An Assessment of Migration Rate and Potential Predictors.

Component Model of Addiction Treatment: A Pragmatic Transdiagnostic Treatment Model of Behavioral and Substance Addictions

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