Recreational Drug Use and Impulsivity in a Population of Canadian Undergraduate Drinkers

The consumption of drugs during young adulthood may be particularly detrimental given important neurodevelopmental changes occurring during this period. As impulsivity may lead to substance use and substance use to the commission of seemingly impulsive acts, an improved understanding of the relationship between alcohol use, other substance use and impulsivity in young adults is important. We gathered information on self-reported impulsivity, recreational drug use, and drinking habits of 205 (105 female) undergraduate students. Results showed that 64% of the students reported using marijuana at least once and these individuals were more likely to report binge drinking. Polysubstance use, defined as using marijuana and at least one other illicit substance, was reported by 20% of students. These individuals reported more drinking occasions per month and had higher levels of trait impulsivity. Rates of recreational drug use were similar to those reported in recent national surveys, suggesting an increase in experimentation with specific illicit drugs. Given that a majority of undergraduate drinkers reported marijuana use and its association with binge drinking, future research should clarify the relationship between marijuana use and binge consumption of alcohol and prevention efforts should consider the conjoint targeting of marijuana and binge drinking. The associations between polysubstance use, binge-level alcohol consumption and elevated self-reported impulsivity suggests that perceived trait impulsivity across multiple domains may predispose to excessive use of multiple substances. Longitudinal studies should examine the contribution of impulsivity to the initiation and experimentation with illicit drugs and the influence of specific substances on impulsivity

Promoting educational, classification, treatment, and policy initiatives : Commentary on: Compulsive sexual behaviour disorder in the ICD-11 (Kraus et al., 2018)

The letter by Kraus et al. (2018) published recently in World Psychiatry presents diagnostic criteria for compulsive sexual behaviors (CSBs). Here, we discuss the potential impact of including CSB disorder in ICD-11 for four areas: educational efforts related to CSB (for both clinicians and patients), investigation of underlying mechanisms and subtypes, development of personalized treatment frameworks, and answering socially important questions and advancing important prevention efforts and effective policies. Each of these four areas has their own challenges that should be addressed, and we briefly describe and discuss them. We hope that this information will help continue a dialog and provide a framework for moving forward in this area

Paroxetine Treatment of Problematic Pornography Use: A Case Series

Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use

Short-Term Internet-Search Training Is Associated with Increased Fractional Anisotropy in the Superior Longitudinal Fasciculus in the Parietal Lobe

The Internet search engine has become an indispensable tool for many people, yet the ways in which Internet searching may alter brain structure and function is poorly understood. In this study, we investigated the influence of short-term Internet-search “training” on white matter microstructure using diffusion tensor imaging (DTI). Fifty-nine valid subjects (Experimental group, 43; Control group, 16) completed the whole procedure: pre- DTI scan, 6-day's training and post- DTI scan. Using track-based spatial statistics, we found increased fractional anisotropy in the right superior longitudinal fasciculus at post-test as compared to pre-test in experimental group. Within the identified region of the right superior longitudinal fasciculus, decreased radial diffusivity (RD), and unchanged axial diffusivity (AD) were observed. These results suggest that short-term Internet-search training may increase white-matter integrity in the right superior longitudinal fasciculus. A possible mechanism for the observed FA change may involve increased myelination after training, although this possibility warrants additional investigation

Detecting associations between behavioral addictions and dopamine agonists in the Food & Drug Administration's Adverse Event database

Abstract Background/Aims Studies have reported higher prevalences of four behavioral addictions (binge eating, compulsive shopping, hypersexuality, and pathological gambling) in dopamine agonist-treated Parkinson's disease relative to non-dopamine agonist-treated Parkinson's. However, recent case-control and epidemiological studies suggest that prevalences of behavioral addictions in dopamine agonist-treated Parkinson's may be similar to background population rates. This study tests that hypothesis by examining the FDA Adverse Event Reporting System (FAERS) for evidence of these associations, taking into account the potential impact of publicity on reporting rates. Methods FAERS reports in 2004 (pre-publicity for all but pathological gambling) and 2007 (post-publicity for all four behaviors) were analyzed. A threshold consisting of ≥3 cases, proportional reporting ratio ≥2, and χ2 with Yates' correction ≥4 was used to detect signals (drug-associated adverse reactions) involving any of five dopamine agonists and any of four behavioral addictions. Results No reports containing compulsive shopping and no signal for binge eating and dopamine agonists were found in either year. A weak signal was found for hypersexuality in 2004, with a stronger signal in 2007. A robust signal was found for pathological gambling in 2004, with a more robust signal in 2007. Discussion/Conclusions These results suggest that publicity may increase reporting rates in the FAERS. Findings for binge eating, compulsive shopping, and hypersexuality suggest that prevalences of these behaviors among those treated with dopamine agonists may be similar to background population rates and thus may not reflect an adverse safety signal. Further investigation of the relationship between dopamine agonists and behavioral addictions is warranted

Publicity and reports of behavioral addictions associated with dopamine agonists

Background The development of behavioral addictions (BAs) in association with dopamine agonists (DAs, commonly used to treat Parkinson’s disease) has been reported. A recent report presented data that these associations are evident in the US Food and Drug Administration’s (FDA) Adverse Event Reporting System (FAERS), a database containing information on adverse drug event and medication error reports submitted to the FDA. However, given that vulnerability to publicity-stimulated reporting is a potential limitation of spontaneous reporting systems like the FAERS, the potential impact of publicity on reporting in this case remains unclear. Method and aims To investigate the potential impact of publicity on FAERS reporting of BAs in association with DAs (BAs w/DAs) as presented by Moore, Glenmullen, and Mattison (2014), news stories covering a BA/DA association were identified and compared with BA w/DA and other reporting data in the FAERS. Results Fluctuations in the growth of BA w/DA reporting to the FAERS between 2003 and 2012 appear to coincide with multiple periods of intensive media coverage of a BA/DA association, a pattern that is not evident in other reporting data in the FAERS. Discussion/Conclusions Publicity may stimulate reporting of adverse events and premature dismissal of the potential influence of publicity on reporting may lead to mistaking an increased risk of an adverse event being reported for an increased risk of an adverse event occurring

Cyberchondria: a Growing Concern During the COVID-19 Pandemic and a Possible Addictive Disorder?

Purpose of Review: The main purpose of this narrative review is to provide a brief overview of the current empirical evidence regarding the conceptualization, assessment, and treatment of cyberchondria, with a focus on the potential classification of cyberchondria as a behavioral addiction. Although cyberchondria has been widely associated with anxiety, it has also been suggested that it may be linked to obsessive–compulsive features. A less explored proposal is the categorization of cyberchondria as a behavioral addiction. The present review explores the existing literature with respect to the possible classification of cyberchondria as a behavioral addiction by considering cyberchondria with respect to components of the interaction of person, affect, cognition and execution model. Recent Findings: There is a lack of consensus regarding the definition and conceptualization of cyberchondria. The empirical evidence available to date suggests that cyberchondria is a multifactorial construct that operates transdiagnostically, particularly with respect to obsessive–compulsive-related disorders and health-related anxiety. The extent to which the condition may reflect a behavioral addiction as a form of problematic use of the internet also warrants consideration. Cyberchondria may have become more prevalent during the COVID-19 pandemic, with particular populations prone to health-related anxiety likely having greater vulnerability. Existing data in part support the potential classification of cyberchondria as a behavioral addiction, although many gaps in understanding currently exist. Summary: Cyberchondria appears to be a growing concern. However, there is not yet enough empirical evidence to determine whether this clinical condition has enough similarities with behavioral addictions to be considered as one. Likewise, psychometric instruments that exist to date have not been designed from the theoretical framework of behavioral addictions, so most of the factors that they evaluate may be preferentially related to anxiety. Finally, there is still no consensus on whether cyberchondria should be addressed in the context of health anxiety interventions, OCRD, or behavioral addictions; thus, more empirical evidence is needed

Risk-taking and decision-making in youth: Relationships to addiction vulnerability

Background: Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Methods: Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationships to addiction vulnerability in youth. Results: Decision-making and risk-taking behaviors involve brain areas that undergo developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Conclusions: Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in addictive behaviors

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research : Defining and classifying non-substance or behavioral addictions

Multiple controversies exist currently in the field of behavioral addictions. The opinion article by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015) proposes an approach to considering which behaviors might be considered as foci for addictions. The article raises multiple important points that foster further dialog and highlight the need for additional research. Given that how specific behaviors are considered from diagnostic and classification perspectives holds significant public health implications, targeting and eliminating current knowledge gaps relating to behavioral addictions is an important undertaking