Module 6 Flashcards
Behavioral Addictions; Gambling Disorder, Food Addiction (22 cards)
What brain area is important both to addiction in general and to regulating food-seeking?
NAcc.
What is one vulnerability factor shared by both SUD and Gambling Disorder (GD)?
Impulsivity
The mesolimbic reward system also seems somehow altered in GD. What contradictory evidence can be seen here?
Some studies point to a hyperactive system (sensitization) and others point to a hypoactive system (reward deficiency).
PET studies measure D2 receptor binding have shown a difference between SUD patients and GD patients. What is it?
There was reduced D2 receptor binding in SUD patients, but not in GD patients.
What can be concluded from dopamine studies on GD?
Pathophysiology in SUD and GD differs, but dopamine is somehow involved in both.
What is the Computational Model of Addiction? (by Redish et al)
Over the course of Pavlovian learning, there’s no more firing to the US (reward) when it’s a natural reward. When it’s a drug, the dopamine response does not diminish. Besides a response to the CS, there is always a response to the US too
-> hyperlearning of drug cues
Drug addicts respond to drug cues strongly. What comparable process in GD is shown by fMRI?
GD patients show greater brain activation for anticipating gambling rewards, but reduced activity to actual wins.
The computational model of addiction was adapted with two new features to implement behavioral addictions. One of them is the Big Win hypothesis. What does it say?
Patients rport having a huge payout the first few times they gambled. These profound positive prediction errors activate reinforcement learning.
Another new feature of the computational model of addiction is asymmetry in temporal-difference learning. What is it?
Financial gains promote learning acquisition, but financial losses do not. Instead, theyy trigger hindsight bias.
What are two cognitive distortions related to conditions of chance?
Illusion of control and Gambler’s fallacy.
What is the Gambler’s fallacy?
The belief that a certain random event is less or more likely to happen based on the outcome of previous events.
What brain area has been shown by research to be causally involved in cognitive distortions in GD?
The insula; lesions in this area led to no enhanced motivation following near misses and no Gambler’s fallacy.
CBT is the most effective treatment for GD. What are components used for GD?
Psychoeducation; FA; Stimulus-control measures; Relapse prevention.
What two pieces of evidence show a similarity between SUD and people with a high BMI?
Reduced D2-receptor density. Similar fMRI profiles.
What are arguments against food addiction?
- Evidence to speak of food addiction as similar to SUD is lacking.
- Substances have addictive elements by themselves, food does not seem to have that.
- Rat studies show reduced dopamine receptor function in high-sugar foods, but these studies do not translate to humans yet.
What are arguments in favor of food addiction?
- Addictions don’t have to overlap completely; they just need to share brain and behavior abnormalities leading to a difficulty to control consumption, which is present in both.
- Addictions are not defined by shared physiological abnormalities, but by negative manifestations.
- Energy-dense food can stimulate changes in activity of many the same brain structures as impacted by drugs.
- Unnatural combos in high-kcal food can be particularly valued by our brains.
What are similarities between SUD and GD?
Similar neuropychology, underlying genetic vulnerabilities. CBT is most effective treatment for both. They tend to be comorbid and have simlar risk factors. Negative reinforcement plays a role in both.
Research with monkeys being rewarded lemonade after a predictor, with varying probabilities, told us something about reward uncertainty. What?
Reward uncertainty increases the dopamine release to a predictor of a reward, and increases dopamine release as a response to reward anticipation.
There are machine design features that increase the addictive potential of machines or games. Name some.
- Timing: quicker, more addictive
- Stakes: higher stakes
- Near-misses
- Disguised losses
- Audiovisual reinforcers
- Reinforcement schedules: variable ratio schedule most addictive
What are some human design features that make you at risk for GD?
Illusion of control; Gambler’s fallacy; impaired executive control; cue reactivity; distorted reward processing.
What does fMRI say about gambling?
Increased reward system activation after near-misses and during anticipation of a gambling outcome. Lower activity after winning.
Healthy controls show a different kind of reward system activation during gambling than GD patients. What do healthy controls show?
Healthy controls show increased NAcc activity when winning and decreased activity during near- and full-misses.
