Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research : Can the emerging domain of behavioral addictions bring a new reflection for the field of addictions, by stressing the issue of the context of addiction development?

Background This paper is a commentary to the article entitled: “Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research”, by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015). Methods and Aims In this manuscript, we commented on two aspects developed by the authors. Billieux et al. (2015) propose that the recent development of propositions of behavioral addiction is driven by an unwise application of an addiction model to excessive behaviors and rests on a confirmatory research strategy that does not question the psychological processes underlying the development of the conduct. They also show that applying a process driven strategy leads to a more appropriate description of the reality of the behavior and conduct, in particular by describing a variety of motivations for the excessive behavior, which is central to understanding the nature of the conduct. We believe that this new approach, which is fruitful to the emerging domain of behavioral addictions, could also apply to the domain of addictions in general. The latter is characterized by the application of a generic biological model, largely influenced by animal models, focusing on neurophysiological determinants of addiction. This approach may have decreased the attention paid to dimensions of addictions that are more specifically human. We will firstly briefly argue on the limitation of this neurophysiological addiction model for the field of excessive behavioral conducts. Secondly, we will argue for an approach centered on the differentiation of motivations and on the adaptive dimension of the behavior when it first developed and on the evocation of a transition where the conduct became independent of its original function. Conclusions The emerging domain of behavioral addictions, where no animal model has been developed so far, may bring a new reflection that may apply to the domain of addictions in general, with a specific attention to human questions

Oxytocin makes us trusting but not gullible

Originally known for its role in childbirth and lactation, oxytocin (OT) has recently proved to play a key role in social behavior. Deprived of OT, humans are unable to recognize and to bond to their peers. Inversely, once boosted with OT, people become more caring, trusting and generous. Effect-sizes on trust and generosity were sufficiently large that OT started to be perceived as a natural drug that would make people credulous. But could OT really impede judgment and lead individuals to trust untrustworthy peers? Here we show that oxytocin makes people trusting, but not gullible. Namely, OT did not have a trust-enhancing effect on people who interacted with seemingly unreliable peers. These results emphasize that the effect of OT is much more context-dependent than previously thought. This finding therefore invalidates some of the potential commercial or military applications of oxytocin

Interference-based methods to mitigate gambling craving: a proof-of-principle pilot study

Craving is central in the prognosis of gambling disorder. The elaborated intrusion theory (EIT) provides a sound framework to account for craving in addictive disorders, and interference methods inspired from the EIT have substantiated their effectiveness in mitigating substance and food-related cravings. The principle of these methods is to recruit the cognitive resources underlying craving (e.g., visuospatial skills, mental imagery) for another competitive and cognitively demanding task, thus reducing the vividness and overwhelming nature of craving. Here we conducted two experiments employing a between-subjects design to test the efficacy of interference methods for reducing laboratory-induced craving. In these experiments, gamblers (n = 38 for both experiments) first followed a craving induction procedure. They then performed either a visuospatial interference task (making a mental and vivid image of a bunch of keys [experiment 1] or playing the video game Tetris [experiment 2]; experimental conditions) or another task supposed not to recruit visuospatial skills and mental imagery (exploding bubble pack [experiment 1] or counting backwards [experiment 2]; control conditions). Results show that all methods successively mitigated induced craving. Although previous research evidenced the superiority of visuospatial tasks to reduce substance-related craving, our findings question their superiority in the context of gambling craving

ADOLESCENTS IN TRANSITION TO YOUNG ADULTHOOD: EVOLUTION OF MENTAL HEALTH STATUS AND RISK FACTORS ASSOCIATED WITH DEPRESSIVE AND ANXIETY DISORDER

Background: In this paper we focus on adolescents in transition towards young adulthood (ATYA). We know from international studies that the transition process makes adolescents vulnerable to mental illness. However, little is known about Belgian ATYA mental-health status. Nor are risk factors associated with their mental illness understood, in particular with regard to depressive and anxiety disorder. The aim of this study is (1) to discuss evolution in time of prevalence of depressive disorder (DD) and anxiety disorder (AD) among Belgian ATYA and (2), to identify risk factors associated with these disorders among ATYA. Subjects and methods: Data was extracted from the Belgian Health Interview Survey (BHIS), which is a cross-sectional population survey, carried out in 2001, 2004, 2008, and 2013. Information about the population’s background characteristics, health services utilization, health behaviours and mental health status were extracted and statistically analyzed. Results: ATYA prevalence of DD and AD was higher in 2013 in comparison with previous years. These changes were significant only for DD (F=4.466, p=0.004). In contrast with younger adolescents, among ATYA odds of DD were 28.2% higher (OR 1.282, 95% CI 0.967-1.698, p=0.084) and, odds of AD were 55.2% higher (OR 1.552, 95% CI 1.137-2.119, p=0.006). For ATYA, a poor quality of social support was the most predictive factor of DD (OR 11.187, 95% CI 5.530-22.629, p<0.0001) and AD (OR 6.238, 95% CI 2.845-13.676, p<0.0001); whereas, having a paid job was the most protective factor with regard to DD (OR 0.282, 95% CI 0.169-0.470, p<0.0001) and AD (OR 0.552, 95% CI 0.330-0.924, p<0.024). Conclusion: Prevalence of mental illness among Belgian ATYA appears to worsen in time. In comparison with younger adolescents, ATYA are more vulnerable to anxiety disorders. Adverse and protective risk factors were identified and discussed in a way to improve access, continuity and mental healthcare pathways for Belgian ATYA

Individual Differences in Impulsivity Predict Anticipatory Eye Movements

Impulsivity is the tendency to act without forethought. It is a personality trait commonly used in the diagnosis of many psychiatric diseases. In clinical practice, impulsivity is estimated using written questionnaires. However, answers to questions might be subject to personal biases and misinterpretations. In order to alleviate this problem, eye movements could be used to study differences in decision processes related to impulsivity. Therefore, we investigated correlations between impulsivity scores obtained with a questionnaire in healthy subjects and characteristics of their anticipatory eye movements in a simple smooth pursuit task. Healthy subjects were asked to answer the UPPS questionnaire (Urgency Premeditation Perseverance and Sensation seeking Impulsive Behavior scale), which distinguishes four independent dimensions of impulsivity: Urgency, lack of Premeditation, lack of Perseverance, and Sensation seeking. The same subjects took part in an oculomotor task that consisted of pursuing a target that moved in a predictable direction. This task reliably evoked anticipatory saccades and smooth eye movements. We found that eye movement characteristics such as latency and velocity were significantly correlated with UPPS scores. The specific correlations between distinct UPPS factors and oculomotor anticipation parameters support the validity of the UPPS construct and corroborate neurobiological explanations for impulsivity. We suggest that the oculomotor approach of impulsivity put forth in the present study could help bridge the gap between psychiatry and physiology

The Associations between Self-Consciousness, Depressive State and Craving to Drink among Alcohol Dependent Patients Undergoing Protracted Withdrawal

Context In order to understand how certain personality traits influence the relation between depression symptoms and craving for alcohol, trait self-consciousness (trait SC) was examined during a withdrawal and detoxification program. Methods: Craving (Obsessive and Compulsive Drinking Scale), depressive state (Beck Depression Inventory) and trait SC (Revised Self-Consciousness Scale) were assessed in alcohol-dependent inpatients (DSM-IV, N = 30) both at the beginning (T1: day 1 or 2) and at the end (T2: day 14 to18) of protracted withdrawal during rehabilitation. Results: A significant decrease in craving and depressive symptoms was observed from T1 to T2, while SC scores remained stable. At both times, strong positive correlations were observed between craving and depression. Moreover, regression analyses indicated that trait SC significantly moderated the impact of depression on cravings for alcohol. Limitations This study was performed on a relatively small sample size. Administration of medications during detoxification treatment can also be a confounding factor. Finally, craving could have been evaluated through other types of measurements. Conclusions: During protracted withdrawal, alcohol craving decreased with the same magnitude as depressive mood. Depressive symptoms were related to alcohol craving but only among patients with high trait SC scores. Our results suggest that metacognitive approaches targeting SC could decrease craving and, in turn, prevent future relapses

Disease recognition is related to specific autobiographical memory deficits in alcohol-dependence

The particularly high treatment gap in alcohol-dependence suggests the existence of important barriers to treatment decision and in particular difficulties in problem recognition. This study tested the relation between problem recognition and self-related memories. Forty-one recently detoxified alcohol-dependent individuals (AD) were compared to twenty alcoholic subjects that were abstinent for 6 months or more (recruited among alcoholics-anonymous (AA)), and to twenty controls on autobiographical memories elicited by pictures depicting or not alcohol using the autobiographical memory test. Autonoetic consciousness was measured with the Remember/Know paradigm. We tested whether memories performances were related with data obtained on the readiness to change questionnaire (RCQ) or with consciousness of the severity of drinking. AD subjects provided less specific memories than control and AA subjects, and fewer Remember responses than controls. The deficits in AD subjects were not specific for memories elicited by pictures depicting alcohol, suggesting a global deficit. Autobiographical memories specificity was negatively correlated to scores of consciousness of the severity of drinking but not to RCQ. Our results support potential recovery of autobiographical memory with abstinence. AD’s deficits in autobiographical memory were related to capacities to recognize the severity and therefore may be a barrier to treatment decision

Psychometric Properties of the Multidimensional Assessment of Covid-19-Related Fears (MAC-RF) in French-Speaking Healthcare Professionals and Community Adults

The Multidimensional Assessment of COVID-19-Related Fears (MAC-RF) is an 8-item self-report measure, which is based on the theoretical premise that fear responses to COVID-19 involve different yet intertwined domains (i.e., bodily, relational, cognitive, and behavioural). In this multi-step study, we tested the psychometric properties of the French version of the MAC-RF and examined the reciprocal relationships among COVID-19-related fears. Data were collected in two French-speaking samples (N = 521 individuals from the community and N = 328 healthcare professionals). Internal reliability, convergent validity, construct validity, and internal structure of the MAC-RF were tested. The French version of the MAC-RF demonstrated good psychometric properties and a two-factor structure, with bodily and relational fears tapping into the first factor, and cognitive and behavioural fears tapping into the second factor. Healthcare professionals reported greater COVID-19-related fears than community participants. Correlation network analysis showed that fear for one’s own body and fear of taking action might increase the risk of experiencing other COVID-19-related fears. Limitations comprised the cross-sectional design of the study, risk of bias associated with self-report instruments, and use of online surveys. A careful assessment of different types of fear related to COVID-19 may have implications for prevention and clinical practice during the current coronavirus pandemic. The French version of the MAC-RF is valid and reliable and can thus be used for this purpose

Correlates of social exclusion in social anxiety Disorder: An fMRI study

Cognitive models posit that social anxiety disorder (SAD) is maintained by biased informationprocessing vis-à-vis threat of social exclusion. However, uncertainty still abounds regarding the very nature of this sensitivity to social exclusion in SAD. Especially, brain alterations related to social exclusion have not been explored in SAD. Our primary purpose was thus to determine both the selfreport and neural correlates of social exclusion in this population. 23 patients with SAD and 23 matched nonanxious controls played a virtual game (“Cyberball”) during fMRI recording. Participants were frst included by other players, then excluded, and fnally re-included. At the behavioral level, patients with SAD exhibited signifcantly higher levels of social exclusion feelings than nonanxious controls. At the brain level, patients with SAD exhibited signifcantly higher activation within the left inferior frontal gyrus relative to nonanxious controls during the re-inclusion phase. Moreover, self-report of social exclusion correlates with the activity of this cluster among individuals qualifying for SAD diagnosis. Our pattern of fndings lends strong support to the notion that SAD may be better portrayed by a poor ability to recover following social exclusion than during social exclusion per se. These fndings value social neuroscience as an innovative procedure to gain new insight into the underlying mechanisms of SAD

Expert appraisal of criteria for assessing gaming disorder : An international Delphi study

© 2021 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (CC-BY-NC-ND - https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Background and aims: Following the recognition of ‘internet gaming disorder’ (IGD) as a condition requiring further study by the DSM-5, ‘gaming disorder’ (GD) was officially included as a diagnostic entity by the World Health Organization (WHO) in the 11th revision of the International Classification of Diseases (ICD-11). However, the proposed diagnostic criteria for gaming disorder remain the subject of debate, and there has been no systematic attempt to integrate the views of different groups of experts. To achieve a more systematic agreement on this new disorder, this study employed the Delphi expert consensus method to obtain expert agreement on the diagnostic validity, clinical utility and prognostic value of the DSM-5 criteria and ICD-11 clinical guidelines for GD. Methods: A total of 29 international experts with clinical and/or research experience in GD completed three iterative rounds of a Delphi survey. Experts rated proposed criteria in progressive rounds until a pre-determined level of agreement was achieved. Results: For DSM-5 IGD criteria, there was an agreement both that a subset had high diagnostic validity, clinical utility and prognostic value and that some (e.g. tolerance, deception) had low diagnostic validity, clinical utility and prognostic value. Crucially, some DSM-5 criteria (e.g. escapism/mood regulation, tolerance) were regarded as incapable of distinguishing between problematic and non-problematic gaming. In contrast, ICD-11 diagnostic guidelines for GD (except for the criterion relating to diminished non-gaming interests) were judged as presenting high diagnostic validity, clinical utility and prognostic value. Conclusions: This Delphi survey provides a foundation for identifying the most diagnostically valid and clinically useful criteria for GD. There was expert agreement that some DSM-5 criteria were not clinically relevant and may pathologize non-problematic patterns of gaming, whereas ICD-11 diagnostic guidelines are likely to diagnose GD adequately and avoid pathologizing.Peer reviewe