Addictive behavior: Difference between revisions

Addiction and dependence glossary^[1]^[2]^[3]
Addiction and dependence glossary
	addiction – a biopsychosocial disorder characterized by persistent use of drugs (including alcohol) despite substantial harm and adverse consequences; addictive drug – psychoactive substances that with repeated use are associated with significantly higher rates of substance use disorders, due in large part to the drug's effect on brain reward systems; dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake); drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose; drug withdrawal – symptoms that occur upon cessation of repeated drug use; physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens); psychological dependence – dependence socially seen as being extremely mild compared to physical dependence (e.g., with enough willpower it could be overcome); reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them; rewarding stimuli – stimuli that the brain interprets as intrinsically positive and desirable or as something to approach; sensitization – an amplified response to a stimulus resulting from repeated exposure to it; substance use disorder – a condition in which the use of substances leads to clinically and functionally significant impairment or distress; tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose;
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An addictive behavior is a behavior, or a stimulus related to a behavior (e.g., sex or food), that is both rewarding and reinforcing, and is associated with the development of an addiction. There are two main forms of addiction: substance use disorders (including alcohol, tobacco, drugs and cannabis) and behavioral addiction (including sex, gambling, eating and shoplifting).^[4] The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.^[5]

Defining addictive behavior presents a challenge, as the concept encompasses diverse behaviors, and therefore its usage has been contentious. Although, central to the definition is excessive dependence on a specific substance or activity, derived from the Latin term ‘to enslave.^[6] Furthermore, addictive behavior describes patterns characterized by a loss of control and a compulsion to accept a reward despite severe consequences. This often manifests in compulsive engagement, prioritizing short-term gratification over long-term consequences, and a transition from impulsivity to compulsivity.^[7] Consequently, addictive behaviors create a spectrum of activities that entrap individuals in repetitive patterns, despite the adverse consequences, echoing the enslavement inherent in the notion of addiction.^[8]

Developments in research continue to reshape our understanding of addiction. Traditionally, addiction was largely associated with substance-use disorders, including alcohol and heroin, and therefore “non-substance-related (behavioral) addiction” was not listed in the two internationally used diagnostic manuals for mental disorders. However, contemporary research suggests that any stimulus capable of producing pleasure can lead to addiction. This shift broadens the scope of addiction to include excessive shopping, internet usage, computer gaming, gambling, and sex.^[9]^[10] Addictive behaviors, whether substance-related or behavioral, often involve deficiencies in inhibitory control, emotion regulation, and decision-making.^[6] There are significant overlaps in diagnostic symptoms between substance use and behavioral addiction, including dominance over one’s life, euphoric experiences, withdrawal symptoms, interpersonal conflicts, and the risk of relapse despite negative outcomes.^[11]

From a neurobiological perspective, behavioral addiction may affect brain neurotransmitter systems similarly to pharmacological substances, such as the dopamine system.^[12] These behaviors often follow a three-step cycle consisting of preoccupation (anticipation), binge intoxication, and withdrawal effect, with reinforcement playing a central role in each stage. Reinforcement occurs through positive experiences during the initial engagement, negative reinforcement to alleviate withdrawal symptoms, and conditioned reinforcement where cues associated with behavior or drugs trigger intense cravings, perpetuating the addiction.^[13]

Addiction is classified as a chronic brain disorder by the American Society of Addiction Medicine (ASAM).^[5] There are several reasons why people develop an addiction. A predisposition to the addictive qualities of substances may be inherited by some people, making it a genetic circumstance. Another cause for addictions could be the environment. Whether or not someone develops substance use problems can be influenced by their home and neighborhood, as well as the attitudes of their peers, family, and culture on substance use.^[5] Another cause of developing an addiction could be related to mental health issues: over 50% of individuals with substance use disorders have experienced mental health issues at some point in their lives. Even moderate substance usage might exacerbate mental health issues in individuals.^[5] The other view is from the moral standpoint which regards addictive behavior as an intentional choice was freely made by the addict.^[14]

How addiction affects the brain

Brain imaging techniques have assisted in mapping neural circuits involved in addictive behaviors, such as reward responses, cravings, cue conditioning, and withdrawal symptoms. This has provided key insights on the underlying mechanisms of addiction, including substance use and non-substance (behavioral) addictions.^[15]

Addiction hijacks the brain’s reward system, which normally encourages individuals to engage in survival-related activities such as socializing, eating, or achieving goals. Substances or specific behavioral activities create an intense “high” by flooding the reward system with dopamine, a chemical commonly known as “a feel-good chemical". Over time, the brain adapts to this surge by dampening its dopamine production and sensitivity to rewards. Consequently, the addicted individual may experience feelings of sluggishness and lack of motivation unless they consume the substance or engage in an activity to attain a sense of normalcy. This cycle of intense pleasure is followed by withdrawal symptoms and cravings, which fuel addiction.^[16]^[15]

Despite the traditional distinction between substance-use addictions and behavioral addictions, research reveals noteworthy similarities in their neurochemical mechanisms.^[17] Brain imaging studies demonstrates that both types of addiction activate similar regions in the mesolimbic reward pathway, a network linked to motivation and pleasure.^[18] Moreover, both involve changes in neurotransmitters, such as dopamine and serotonin, which are responsible for regulating mood, impulse control and reward processing. These convergent neurochemical features suggest that substance dependence and non-substance addictions follow similar fundamental stages.^[17]

The key stages of addiction are as follows:

Intoxication: Addictive substances induce dopamine surges in the mesolimbic reward system during intoxication, reinforcing a pleasurable high and establishing associations between drug-related cues and the anticipation of rewards

Adaptation: Individuals with addiction exhibit reduced dopamine production, leading to diminished sensitivity with repeated use. Besides dopamine, other neurotransmitters, such as serotonin and opioids, contribute to initial pleasurable effects (euphoria) and are also impacted by the brain's adaptation to repeated use.

Withdrawal: Upon cessation of the behavior or the drug effect wearing off, individuals experience negative mood states, including anxiety and anhedonia, due to the dampened reward system. Withdrawal processes are mediated by basal forebrain areas and neurotransmitters such as corticotropin-releasing factor (CRF) and norepinephrine.

Cravings: Conditioned cues (sight, smell, and emotions) drive cravings, prompting individuals to seek a re-experience of euphoria. Prefrontal circuits involved in highlighting the substance or addictive behavior’s importance are activated, while the limbic region triggers an automatic response encouraging the pursuit of the activity or substance. Dusyfuntioning in prefrontal cortical regions impairs executive functions, making it difficult to resist craving despite adverse consequences.^[15]

These overlapping neurochemical features support the growing understanding of addiction as a border phenomenon, impacting substance-use and behavioral addictions.^[17]

Compulsion vs addiction

Compulsions are the basis of addictions. Reward is one major distinction between compulsion in addicts and compulsion as it is experienced in obsessive-compulsive disorder. An addiction is, by definition, a form of compulsion, and involves operant reinforcement. For example, dopamine is released in the brain's reward system and is a motive for behaviour (i.e. the compulsions in addiction development through positive reinforcement).^[19]

There are two main differences between compulsion and addiction. Compulsion is the need and desire to do something or carry out a task repetitively or persistently. Whereas addiction is defined by the following step after compulsion where an individual takes action on a compulsion to feel pleasure and satisfaction (the action is known as compulsive behavior). Notably, for addicts, compulsive behavior can lead to “persistent changes in the brain structures and functions” which creates a cycle of motivation for their behavior that is absent in OCD.^[14]

Compulsions (and compulsive behavior) do not necessarily include pleasure for the individual but addictive behavior does. In contrast, someone who experiences a compulsion as part of obsessive-compulsive disorder may not perceive anything rewarding from acting on the compulsion. Often, it is a way of dealing with the obsessive part of the disorder, resulting in a feeling of relief (i.e., compulsions may also arise through negative reinforcement).^[20]

Correlation between different personality traits and addictive behaviors online

For over a decade, scientists have emphasized that contact with digital technology can potentially lead to addiction. People of all ages utilize digital devices, and their numbers are growing annually. Accordingly, excessive internet use can result in unhealthy internet use, also known as internet addiction.^[21]

It's been proven that the big five personality traits and internet addiction are associated. A recent study aimed to examine the relationships between the big five personality traits and internet addiction within this framework.^[22] As such, the researchers employed the meta-analysis method. In accordance with the study's goal, twelve papers were included in the meta-analysis, and thirteen effect sizes were derived from these investigations.^[22] In this case, it was shown that agreeableness, conscientiousness, extraversion, and openness to new experiences were inversely correlated with internet addiction, while neuroticism was positively correlated with it. As a result, it's thought that the big five personality traits play a significant role in the development of an internet addiction.^[22]

Another study focuses on neuroticism, which has been frequently proven to be a risk factor for internet addiction. The following categories were used to summarize the concepts related to neuroticism and internet addiction: internalizing problems, externalizing problems, coping style, and other factors.^[23] The most significant finding from the study is that, with rare exceptions, internet addiction has been primarily included as an outcome and all other ideas as predictors.^[23] Internalizing problems comprise the most consistent subset of the topics in the study. In addition to having a positive correlation, neuroticism and internalizing problems were independent predictors of internet, smartphone, and social media addiction. Regarding externalizing problems—which were often the subject of less research—the same picture became apparent.^[23] The review's findings also demonstrated that, similar to neurotic people's difficulties with emotion regulation, the internet provides them with a special setting in which to deal with unpleasant emotions. Furthermore, having poor-quality social relationships increases the risk of developing internet addiction and other digital addictions, particularly in those with high levels of neuroticism.^[23]

Development of addictive behaviors in adolescents

Given the similarities between substance use addictions and behavioral addictions, the risk factors for susceptibility appear similar, with age of onset (adolescence) being a key factor.^[24] Adolescence is a period of time characterized by significant changes of physical, cognitive and emotional nature.^[25] Adolescents are discovering their individuality and struggle to balance their independence with peer conformity.^[25] During this transitional period, adolescents are therefore vulnerable to developing addictive behaviors.

Epidemiological studies reveal that recreational users differentiate from those with substance use disorders. Research suggests a correlation between individuals who initiate substance use during adolescence and developing a substance use addiction, progressing rapidly from trial to the adverse consequences of addiction. Substance usage increases in late adolescence and young adulthood, with alcohol, marijuana, and tobacco being the most widely consumed substances.^[24]

Brain maturation during adolescence is more susceptible to developing addictive behaviors as it further promotes risk-taking behaviors and subsequently early addiction decisions.^[26] This has been corroborated by animal studies, revealing that biological factors may desensitize adolescents to the sedative effects of chemical substances, such as alcohol, leading to increased consumption during the teenage years,^[27] In fact, drug or alcohol-induced addictive behaviors in adolescents have been linked to models discussing a stronger sensitization of the appetitive response and disrupted inhibitory control.^[28] Moreover, the susceptibility of adolescents is heightened as they tend to weigh the rewarding effects of the activity or stimulus more heavily than the negative effects, while also being less sensitive to withdrawal effects. In early adolescence, individuals lack the motivation to control appetitive motivational tendencies.^[28] The presence of positive and negative reinforcers seem to increase alcohol consumption, portraying a positive correlation between motives and alcohol consumption.^[28] After initiating drinking, there seems to be an increase in appetitive motivation to drink and a negative effect on controlled regulatory processes.^[28] The imbalance between these factors lead to increased substance use.^[28] Although there have been declines in adolescent substance use rates, trends of rising e-cigarette (vape) usage highlight the ongoing health care concern regarding adolescent substance use and its effects on neurodevelopment processes during this crucial developmental stage.^[29]

In addition to the environmental influences, there seems to be a genetic role in adolescent addictive behaviors. Addiction risk alleles can increase the risk of addictive behaviors in teens.^[30] Furthermore, the prefrontal cortex, the region responsible for decision making and executive function, is still developing during adolescence.^[31] This creates a vulnerability and the initiation of addictive behavior during this developmental stage can thus affect long-term functioning.^[31]

Therapy for addictions

Therapy for addictions is not a cure, but a way of managing addictive behaviors.^[32] It is a treatment tailored to the specific triggers and root causes affecting each patient (such as trauma, stress, or anxiety),^[33] and that "enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives."^[32]

Various therapeutic approaches exist to assist individuals in modifying addictive behaviors (i.e.: such as yoga therapy, which can “treat or prevent addiction”),.^[34] However, individuals seeking therapy for addictive behaviors may benefit significantly from consulting with a therapist recognized by medical institutions for their expertise in addiction or compulsion.^[33]

While medical interventions may be necessary for physical detoxification in certain cases, “addiction therapy or addiction counseling is focused on treating psychological addiction”.^[35] For instance, individuals may engage in addictive behaviors to cope with “historical trauma”, necessitating a therapist to use trauma focused cognitive behavioral therapy or exposure therapy to address past issues.^[35] Alternatively, for those using addictive behaviors to cope with current events, therapy addiction may focus on “learning stress management techniques and emotional regulation skills”, including cognitive behavioral therapy or acceptance and commitment therapy.^[35] In other cases, when addiction is intertwined with mental health issues, therapists employ an integrated approach, addressing conditions (i.e.: depression, anxiety, or bipolar disorder) alongside the addiction through procedures such as dialectical behavior therapy or hypnotherapy.^[35]

The use of these treatments is increasing in the medical field, as “a shift is occurring to mainstream the delivery of early intervention and treatment services into general health care practice”.^[36]

References

^ Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues in Clinical Neuroscience. 15 (4): 431–443. PMC 3898681. PMID 24459410. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type [nucleus accumbens] neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state.⁴¹ ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict.
^ Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY (eds.). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 364–375. ISBN 978-0-07-148127-4.
^ Volkow ND, Koob GF, McLellan AT (January 2016). "Neurobiologic Advances from the Brain Disease Model of Addiction". New England Journal of Medicine. 374 (4): 363–371. doi:10.1056/NEJMra1511480. PMC 6135257. PMID 26816013. Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.
Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.
^ "Top 10 Most Common Addictions in the U.S." Addiction Center. Retrieved 2021-03-07.
^ ^a ^b ^c ^d "Addiction". Cleveland Clinic. Retrieved 2023-11-07.
^ ^a ^b Yücel M, Lubman DI, Solowij N, Brewer WJ (December 2007). "Understanding drug addiction: a neuropsychological perspective". The Australian and New Zealand Journal of Psychiatry. 41 (12): 957–968. doi:10.1080/00048670701689444. PMID 17999268.
^ Everitt BJ, Dickinson A, Robbins TW (October 2001). "The neuropsychological basis of addictive behaviour". Brain Research. Brain Research Reviews. 36 (2–3): 129–138. doi:10.1016/s0165-0173(01)00088-1. PMID 11690609.
^ Heather N (December 2017). "Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience?". Addictive Behaviors Reports. 6: 15–38. doi:10.1016/j.abrep.2017.05.002. PMID 29450234.
^ Popescu A, Marian M, Drăgoi AM, Costea RV (May 2021). "Understanding the genetics and neurobiological pathways behind addiction (Review)". Experimental and Therapeutic Medicine. 21 (5): 544. doi:10.3892/etm.2021.9976. PMC 8014976. PMID 33815617.
^ Grant JE, Potenza MN, Weinstein A, Gorelick DA (September 2010). "Introduction to behavioral addictions". The American Journal of Drug and Alcohol Abuse. 36 (5): 233–241. doi:10.3109/00952990.2010.491884. PMC 3164585. PMID 20560821.
^ Alavi SS, Ferdosi M, Jannatifard F, Eslami M, Alaghemandan H, Setare M (April 2012). "Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views". International Journal of Preventive Medicine. 3 (4): 290–294. PMC 3354400. PMID 22624087.
^ Foddy B (January 2011). "Addiction and its sciences-philosophy". Addiction. 106 (1): 25–31. doi:10.1111/j.1360-0443.2010.03158.x. PMID 20955490.
^ Koob GF, Simon EJ (January 2009). "The Neurobiology of Addiction: Where We Have Been and Where We Are Going". Journal of Drug Issues. 39 (1): 115–132. doi:10.1177/002204260903900110. PMC 2901107. PMID 20622969.
^ ^a ^b Henden E, Melberg HO, Røgeberg OJ (2013). "Addiction: choice or compulsion?". Frontiers in Psychiatry. 4: 77. doi:10.3389/fpsyt.2013.00077. PMC 3736117. PMID 23966955.
^ ^a ^b ^c Volkow ND, Boyle M (August 2018). "Neuroscience of Addiction: Relevance to Prevention and Treatment". The American Journal of Psychiatry. 175 (8): 729–740. doi:10.1176/appi.ajp.2018.17101174. PMID 29690790.
^ MacNicol B (February 2017). "The biology of addiction". Canadian Journal of Anaesthesia = Journal Canadien d'Anesthesie. 64 (2): 141–148. doi:10.1007/s12630-016-0771-2. PMID 27837404.
^ ^a ^b ^c Potenza MN (September 2006). "Should addictive disorders include non-substance-related conditions?". Addiction. 101 (s1): 142–151. doi:10.1111/j.1360-0443.2006.01591.x. PMID 16930171.
^ Spanagel R, Heilig M (December 2005). "Addiction and its brain science". Addiction. 100 (12): 1813–1822. doi:10.1111/j.1360-0443.2005.01260.x. PMID 16367982.
^ Solinas M, Belujon P, Fernagut PO, Jaber M, Thiriet N (April 2019). "Dopamine and addiction: what have we learned from 40 years of research". Journal of Neural Transmission. 126 (4): 481–516. PMID 30569209.
^ "NIMH » Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over". www.nimh.nih.gov. Retrieved 2020-10-13.
^ Rachubińska K, Cybulska A, Szkup M, Grochans E (March 2021). "Analysis of the relationship between personality traits and Internet addiction". European Review for Medical and Pharmacological Sciences. 25 (6): 2591–2599. doi:10.26355/eurrev_202103_25422. PMID 33829445.
^ ^a ^b ^c Kayiş AR, Satici SA, Yilmaz MF, Şimşek D, Ceyhan E, Bakioğlu F (2016-10-01). "Big five-personality trait and internet addiction". Computers in Human Behavior. 63 (C): 35–40. doi:10.1016/j.chb.2016.05.012. ISSN 0747-5632.
^ ^a ^b ^c ^d Marciano L, Camerini AL, Schulz PJ (February 2022). "Neuroticism and internet addiction: What is next? A systematic conceptual review". Personality and Individual Differences. 185: 111260. doi:10.1016/j.paid.2021.111260. ISSN 0191-8869.
^ ^a ^b Winters KC, Arria A (2011). "Adolescent Brain Development and Drugs". The Prevention Researcher. 18 (2): 21–24. PMC 3399589. PMID 22822298.
^ ^a ^b Tzavela EC, Mavromati FM (2013). "Online social networking in adolescence: Associations with development, well-being and internet addictive behaviors". International Journal of Adolescence. 6 (4): 411–420. ISSN 1939-5930.
^ Nawi AM, Ismail R, Ibrahim F, Hassan MR, Manaf MR, Amit N, et al. (November 2021). "Risk and protective factors of drug abuse among adolescents: a systematic review". BMC Public Health. 21 (1): 2088. doi:10.1186/s12889-021-11906-2. PMC 8590764. PMID 34774013.{{cite journal}}: CS1 maint: unflagged free DOI (link)
^ Schramm-Sapyta NL, Walker QD, Caster JM, Levin ED, Kuhn CM (September 2009). "Are adolescents more vulnerable to drug addiction than adults? Evidence from animal models". Psychopharmacology. 206 (1): 1–21. doi:10.1007/s00213-009-1585-5. PMC 3025448. PMID 19547960.
^ ^a ^b ^c ^d ^e Wiers RW, Bartholow BD, van den Wildenberg E, Thush C, Engels RC, Sher KJ, et al. (February 2007). "Automatic and controlled processes and the development of addictive behaviors in adolescents: a review and a model". Pharmacology, Biochemistry, and Behavior. 86 (2): 263–283. doi:10.1016/j.pbb.2006.09.021. PMID 17116324. S2CID 18979706.
^ Hamidullah S, Thorpe HH, Frie JA, Mccurdy RD, Khokhar JY (2020-08-04). "Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates". Frontiers in Human Neuroscience. 14: 298. doi:10.3389/fnhum.2020.00298. PMC 7418456. PMID 32848673.{{cite journal}}: CS1 maint: unflagged free DOI (link)
^ Blum K, Febo M, Smith DE, Roy AK, Demetrovics Z, Cronjé FJ, et al. (May 2015). "Neurogenetic and epigenetic correlates of adolescent predisposition to and risk for addictive behaviors as a function of prefrontal cortex dysregulation". Journal of Child and Adolescent Psychopharmacology. 25 (4): 286–292. doi:10.1089/cap.2014.0146. PMC 4442554. PMID 25919973.
^ ^a ^b Hammond CJ, Mayes LC, Potenza MN (April 2014). "Neurobiology of adolescent substance use and addictive behaviors: treatment implications". Adolescent Medicine. 25 (1): 15–32. PMC 4446977. PMID 25022184.
^ ^a ^b "Treatment and Recovery I National Institute on Drug Abuse (NIDA)". nida.nih.gov. Retrieved 2023-11-13.
^ ^a ^b Chabert C (2015-03-04), "Obsessions, addictions, compulsions : contraintes narcissiques et fantasme d'inceste", Les travaux forcés de la répétition, Petite bibliothèque de psychanalyse, Presses Universitaires de France, pp. 19–40, doi:10.3917/puf.andre.2015.03.0019, ISBN 9782130653455, retrieved 2022-04-22
^ Khanna S, Greeson JM (June 2013). "A narrative review of yoga and mindfulness as complementary therapies for addiction". Complementary Therapies in Medicine. 21 (3): 244–252. doi:10.1016/j.ctim.2013.01.008. PMID 23642957.
^ ^a ^b ^c ^d "Addiction Counselling". Psychology Edmonton Psychology - Firefly Counselling. Retrieved 2023-11-13.
^ "Early Intervention, Treatment, and Management of Substance Use Disorders", Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health, US Department of Health and Human Services, retrieved 2023-11-13

External links

VideoJug video on "What is behavioral addiction?"

[Cellular_basis-1] Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues in Clinical Neuroscience. 15 (4): 431–443. PMC 3898681. PMID 24459410. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type [nucleus accumbens] neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state.⁴¹ ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict.

[Addiction_glossary-2] Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY (eds.). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 364–375. ISBN 978-0-07-148127-4.

[Brain_disease-3] Volkow ND, Koob GF, McLellan AT (January 2016). "Neurobiologic Advances from the Brain Disease Model of Addiction". New England Journal of Medicine. 374 (4): 363–371. doi:10.1056/NEJMra1511480. PMC 6135257. PMID 26816013. Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.
Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.

[4] "Top 10 Most Common Addictions in the U.S." Addiction Center. Retrieved 2021-03-07.

[Cleveland_Clinic-5] "Addiction". Cleveland Clinic. Retrieved 2023-11-07.

[Yücel_2007-6] Yücel M, Lubman DI, Solowij N, Brewer WJ (December 2007). "Understanding drug addiction: a neuropsychological perspective". The Australian and New Zealand Journal of Psychiatry. 41 (12): 957–968. doi:10.1080/00048670701689444. PMID 17999268.

[7] Everitt BJ, Dickinson A, Robbins TW (October 2001). "The neuropsychological basis of addictive behaviour". Brain Research. Brain Research Reviews. 36 (2–3): 129–138. doi:10.1016/s0165-0173(01)00088-1. PMID 11690609.

[8] Heather N (December 2017). "Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience?". Addictive Behaviors Reports. 6: 15–38. doi:10.1016/j.abrep.2017.05.002. PMID 29450234.

[9] Popescu A, Marian M, Drăgoi AM, Costea RV (May 2021). "Understanding the genetics and neurobiological pathways behind addiction (Review)". Experimental and Therapeutic Medicine. 21 (5): 544. doi:10.3892/etm.2021.9976. PMC 8014976. PMID 33815617.

[10] Grant JE, Potenza MN, Weinstein A, Gorelick DA (September 2010). "Introduction to behavioral addictions". The American Journal of Drug and Alcohol Abuse. 36 (5): 233–241. doi:10.3109/00952990.2010.491884. PMC 3164585. PMID 20560821.

[11] Alavi SS, Ferdosi M, Jannatifard F, Eslami M, Alaghemandan H, Setare M (April 2012). "Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views". International Journal of Preventive Medicine. 3 (4): 290–294. PMC 3354400. PMID 22624087.

[12] Foddy B (January 2011). "Addiction and its sciences-philosophy". Addiction. 106 (1): 25–31. doi:10.1111/j.1360-0443.2010.03158.x. PMID 20955490.

[13] Koob GF, Simon EJ (January 2009). "The Neurobiology of Addiction: Where We Have Been and Where We Are Going". Journal of Drug Issues. 39 (1): 115–132. doi:10.1177/002204260903900110. PMC 2901107. PMID 20622969.

[Henden_2013-14] Henden E, Melberg HO, Røgeberg OJ (2013). "Addiction: choice or compulsion?". Frontiers in Psychiatry. 4: 77. doi:10.3389/fpsyt.2013.00077. PMC 3736117. PMID 23966955.

[Volkow_2018-15] Volkow ND, Boyle M (August 2018). "Neuroscience of Addiction: Relevance to Prevention and Treatment". The American Journal of Psychiatry. 175 (8): 729–740. doi:10.1176/appi.ajp.2018.17101174. PMID 29690790.

[16] MacNicol B (February 2017). "The biology of addiction". Canadian Journal of Anaesthesia = Journal Canadien d'Anesthesie. 64 (2): 141–148. doi:10.1007/s12630-016-0771-2. PMID 27837404.

[Potenza_2006-17] Potenza MN (September 2006). "Should addictive disorders include non-substance-related conditions?". Addiction. 101 (s1): 142–151. doi:10.1111/j.1360-0443.2006.01591.x. PMID 16930171.

[18] Spanagel R, Heilig M (December 2005). "Addiction and its brain science". Addiction. 100 (12): 1813–1822. doi:10.1111/j.1360-0443.2005.01260.x. PMID 16367982.

[19] Solinas M, Belujon P, Fernagut PO, Jaber M, Thiriet N (April 2019). "Dopamine and addiction: what have we learned from 40 years of research". Journal of Neural Transmission. 126 (4): 481–516. PMID 30569209.

[20] "NIMH » Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over". www.nimh.nih.gov. Retrieved 2020-10-13.

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@@ Line 1: / Line 1: @@
 {{addiction glossary|reverse citation order=yes}}
+{{cs1 config|name-list-style=vanc|display-authors=6}}
-An '''addictive behavior''' is a behavior, or a stimulus related to a behavior (e.g., sex or food), that is both [[reward system|rewarding]] and [[reinforcing]], and is associated with the development of an [[addiction]]. There are two main forms of addiction: substance use disorders (including alcohol, tobacco, drugs and cannabis) and behavioral addiction (including sex, gambling, eating and shoplifting).<ref name=":5">{{Cite web|title=Top 10 Most Common Addictions in the U.S.|url=https://www.addictioncenter.com/addiction/10-most-common-addictions/|access-date=2021-03-07|website=Addiction Center|language=en-US}}</ref> The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.<ref name=":4">{{Cite web |title=Addiction |url=https://my.clevelandclinic.org/health/diseases/6407-addiction |access-date=2023-11-07 |website=Cleveland Clinic |language=en}}</ref>
+An '''addictive behavior''' is a behavior, or a stimulus related to a behavior (e.g., sex or food), that is both [[reward system|rewarding]] and [[reinforcing]], and is associated with the development of an [[addiction]]. There are two main forms of addiction: substance use disorders (including alcohol, tobacco, drugs and cannabis) and behavioral addiction (including sex, gambling, eating and shoplifting).<ref>{{Cite web|title=Top 10 Most Common Addictions in the U.S. |url= https://www.addictioncenter.com/addiction/10-most-common-addictions/|access-date=2021-03-07|website=Addiction Center |language=en-US }}</ref> The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.<ref name="Cleveland Clinic">{{Cite web |title=Addiction |url=https://my.clevelandclinic.org/health/diseases/6407-addiction |access-date=2023-11-07 |website=Cleveland Clinic |language=en}}</ref>
-Defining addictive behavior presents a challenge, as the concept encompasses diverse behaviors, and therefore its usage has been contentious. Although, central to the definition is excessive dependence on a specific substance or activity, derived from the Latin term ‘to enslave<ref name=":11">{{Cite journal |last=Yücel |first=Murat |last2=Lubman |first2=Dan I. |last3=Solowij |first3=Nadia |last4=Brewer |first4=Warrick J. |date=December 2007 |title=Understanding Drug Addiction: A Neuropsychological Perspective |url=http://journals.sagepub.com/doi/10.1080/00048670701689444 |journal=Australian & New Zealand Journal of Psychiatry |language=en |volume=41 |issue=12 |pages=957–968 |doi=10.1080/00048670701689444 |issn=0004-8674}}</ref>. Furthermore, addictive behavior describes patterns characterized by a loss of control and a compulsion to accept a reward despite severe consequences. This often manifests in compulsive engagement, prioritizing short-term gratification over long-term consequences, and a transition from impulsivity to compulsivity<ref>{{Cite journal |last=Everitt |first=Barry J |last2=Dickinson |first2=Anthony |last3=Robbins |first3=Trevor W |date=October 2001 |title=The neuropsychological basis of addictive behaviour |url=https://doi.org/10.1016/S0165-0173(01)00088-1 |journal=Brain Research Reviews |volume=36 |issue=2-3 |pages=129–138 |doi=10.1016/s0165-0173(01)00088-1 |issn=0165-0173}}</ref>. Consequently, addictive behaviors create a spectrum of activities that entrap individuals in repetitive patterns, despite the adverse consequences, echoing the enslavement inherent in the notion of addiction<ref>{{Cite journal |last=Heather |first=Nick |date=December 2017 |title=Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience? |url=https://www.sciencedirect.com/science/article/pii/S2352853217300342 |journal=Addictive Behaviors Reports |volume=6 |pages=15-38 |via=Science Direct}}</ref>.
+Defining addictive behavior presents a challenge, as the concept encompasses diverse behaviors, and therefore its usage has been contentious. Although, central to the definition is excessive dependence on a specific substance or activity, derived from the Latin term ‘to enslave.<ref name="Yücel_2007">{{cite journal | vauthors = Yücel M, Lubman DI, Solowij N, Brewer WJ | title = Understanding drug addiction: a neuropsychological perspective | journal = The Australian and New Zealand Journal of Psychiatry | volume = 41 | issue = 12 | pages = 957–968 | date = December 2007 | pmid = 17999268 | doi = 10.1080/00048670701689444 }}</ref> Furthermore, addictive behavior describes patterns characterized by a loss of control and a compulsion to accept a reward despite severe consequences. This often manifests in compulsive engagement, prioritizing short-term gratification over long-term consequences, and a transition from impulsivity to compulsivity.<ref>{{cite journal | vauthors = Everitt BJ, Dickinson A, Robbins TW | title = The neuropsychological basis of addictive behaviour | journal = Brain Research. Brain Research Reviews | volume = 36 | issue = 2-3 | pages = 129–138 | date = October 2001 | pmid = 11690609 | doi = 10.1016/s0165-0173(01)00088-1 }}</ref> Consequently, addictive behaviors create a spectrum of activities that entrap individuals in repetitive patterns, despite the adverse consequences, echoing the enslavement inherent in the notion of addiction.<ref>{{cite journal | vauthors = Heather N | title = Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience? | journal = Addictive Behaviors Reports | volume = 6 | pages = 15–38 | date = December 2017 | pmid = 29450234 | doi = 10.1016/j.abrep.2017.05.002 }}</ref>
-Developments in research continue to reshape our understanding of addiction. Traditionally, addiction was largely associated with substance-use disorders, including alcohol and heroin, and therefore “non-substance-related (behavioral) addiction” was not listed in the two internationally used diagnostic manuals for mental disorders. However, contemporary research suggests that any stimulus capable of producing pleasure can lead to addiction. This shift broadens the scope of addiction to include excessive shopping, internet usage, computer gaming, gambling, and sex<ref>{{Cite journal |last=Popescu |first=Alexandra |last2=Marian |first2=Maria |last3=Drăgoi |first3=Ana Miruna |last4=Costea |first4=Radu-Virgil |date=2021-05-01 |title=Understanding the genetics and neurobiological pathways behind addiction (Review) |url=https://www.spandidos-publications.com/10.3892/etm.2021.9976 |journal=Experimental and Therapeutic Medicine |volume=21 |issue=5 |pages=1–10 |doi=10.3892/etm.2021.9976 |issn=1792-0981 |pmc=8014976 |pmid=33815617 |via=Spandidos Publications}}</ref><ref>{{Cite journal |last=Grant |first=Jon E. |last2=Potenza |first2=Marc N. |last3=Weinstein |first3=Aviv |last4=Gorelick |first4=David A. |date=2011-09-01 |title=Introduction to Behavioral Addictions |url=https://www.tandfonline.com/doi/full/10.3109/00952990.2010.491884 |journal=The American Journal of Drug and Alcohol Abuse |language=en |volume=36 |issue=5 |pages=233–241 |doi=10.3109/00952990.2010.491884 |issn=0095-2990 |pmc=3164585 |pmid=20560821 |via=PubMed Central}}</ref>. Addictive behaviors, whether substance-related or behavioral, often involve deficiencies in [[Inhibitory control|inhibitory control,]] [[emotion regulation]], and [[decision-making]]<ref name=":11" />. There are significant overlaps in diagnostic symptoms between substance use and behavioral addiction, including dominance over one’s life, [[Euphoria|euphoric]] experiences, withdrawal symptoms, interpersonal conflicts, and the risk of relapse despite negative outcomes<ref>{{Cite journal |last=Alavi |first=Seyyed Salman |last2=Ferdosi |first2=Masoud |last3=Jannatifard |first3=Fereshte |last4=Eslami |first4=Mehdi |last5=Alaghemandan |first5=Hamed |last6=Setare |first6=Mehrdad |date=April 2012 |title=Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/ |journal=International Journal of Preventive Medicine |volume=3 |issue=4 |pages=290–294 |issn=2008-7802 |pmc=3354400 |pmid=22624087}}</ref>.
+Developments in research continue to reshape our understanding of addiction. Traditionally, addiction was largely associated with substance-use disorders, including alcohol and heroin, and therefore “non-substance-related (behavioral) addiction” was not listed in the two internationally used diagnostic manuals for mental disorders. However, contemporary research suggests that any stimulus capable of producing pleasure can lead to addiction. This shift broadens the scope of addiction to include excessive shopping, internet usage, computer gaming, gambling, and sex.<ref>{{cite journal | vauthors = Popescu A, Marian M, Drăgoi AM, Costea RV | title = Understanding the genetics and neurobiological pathways behind addiction (Review) | journal = Experimental and Therapeutic Medicine | volume = 21 | issue = 5 | pages = 544 | date = May 2021 | pmid = 33815617 | pmc = 8014976 | doi = 10.3892/etm.2021.9976 }}</ref><ref>{{cite journal | vauthors = Grant JE, Potenza MN, Weinstein A, Gorelick DA | title = Introduction to behavioral addictions | journal = The American Journal of Drug and Alcohol Abuse | volume = 36 | issue = 5 | pages = 233–241 | date = September 2010 | pmid = 20560821 | pmc = 3164585 | doi = 10.3109/00952990.2010.491884 }}</ref> Addictive behaviors, whether substance-related or behavioral, often involve deficiencies in [[Inhibitory control|inhibitory control,]] [[emotion regulation]], and [[decision-making]].<ref name="Yücel_2007" /> There are significant overlaps in diagnostic symptoms between substance use and behavioral addiction, including dominance over one’s life, [[Euphoria|euphoric]] experiences, withdrawal symptoms, interpersonal conflicts, and the risk of relapse despite negative outcomes.<ref>{{cite journal | vauthors = Alavi SS, Ferdosi M, Jannatifard F, Eslami M, Alaghemandan H, Setare M | title = Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views | journal = International Journal of Preventive Medicine | volume = 3 | issue = 4 | pages = 290–294 | date = April 2012 | pmid = 22624087 | pmc = 3354400 }}</ref>
-From a neurobiological perspective, behavioral addiction may affect brain neurotransmitter systems similarly to pharmacological substances, such as the [[dopamine system]]<ref>{{Cite journal |last=Foddy |first=Bennett |date=2010-10-19 |title=Addiction and its sciences-philosophy |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03158.x |journal=Addiction |language=en |volume=106 |issue=1 |pages=25–31 |doi=10.1111/j.1360-0443.2010.03158.x |via=Wiley}}</ref>. These behaviors often follow a three-step cycle consisting of preoccupation (anticipation), binge intoxication, and withdrawal effect, with reinforcement playing a central role in each stage. [[Reinforcement]] occurs through positive experiences during the initial engagement, negative reinforcement to alleviate withdrawal symptoms, and conditioned reinforcement where cues associated with behavior or drugs trigger intense cravings, perpetuating the addiction<ref>{{Cite journal |last=Koob |first=George F. |last2=Simon |first2=Eric J. |date=2009-01-01 |title=The Neurobiology of Addiction: Where We Have Been and Where We Are Going |url=http://journals.sagepub.com/doi/10.1177/002204260903900110 |journal=Journal of Drug Issues |language=en |volume=39 |issue=1 |pages=115–132 |doi=10.1177/002204260903900110 |issn=0022-0426 |pmc=2901107 |pmid=20622969}}</ref>.
+From a neurobiological perspective, behavioral addiction may affect brain neurotransmitter systems similarly to pharmacological substances, such as the [[dopamine system]].<ref>{{cite journal | vauthors = Foddy B | title = Addiction and its sciences-philosophy | journal = Addiction | volume = 106 | issue = 1 | pages = 25–31 | date = January 2011 | pmid = 20955490 | doi = 10.1111/j.1360-0443.2010.03158.x }}</ref> These behaviors often follow a three-step cycle consisting of preoccupation (anticipation), binge intoxication, and withdrawal effect, with reinforcement playing a central role in each stage. [[Reinforcement]] occurs through positive experiences during the initial engagement, negative reinforcement to alleviate withdrawal symptoms, and conditioned reinforcement where cues associated with behavior or drugs trigger intense cravings, perpetuating the addiction.<ref>{{cite journal | vauthors = Koob GF, Simon EJ | title = The Neurobiology of Addiction: Where We Have Been and Where We Are Going | journal = Journal of Drug Issues | volume = 39 | issue = 1 | pages = 115–132 | date = January 2009 | pmid = 20622969 | pmc = 2901107 | doi = 10.1177/002204260903900110 }}</ref>
-Addiction is classified as a chronic brain disorder by the [[American Society of Addiction Medicine]] (ASAM).<ref name=":4" /> There are several reasons why people develop an addiction. A predisposition to the addictive qualities of substances may be inherited by some people, making it a genetic circumstance. Another cause for addictions could be the environment. Whether or not someone develops substance use problems can be influenced by their home and neighborhood, as well as the attitudes of their peers, family, and culture on substance use.<ref name=":4" /> Another cause of developing an addiction could be related to mental health issues: over 50% of individuals with substance use disorders have experienced mental health issues at some point in their lives. Even moderate substance usage might exacerbate mental health issues in individuals.<ref name=":4" /> The other view is from the moral standpoint which regards addictive behavior as an intentional choice was freely made by the addict.<ref name=":0">{{Cite journal |last1=Henden |first1=Edmund |last2=Melberg |first2=Hans Olav |last3=Røgeberg |first3=Ole Jørgen |date=2013 |title=Addiction: Choice or Compulsion? |journal=Frontiers in Psychiatry |volume=4 |page=77 |doi=10.3389/fpsyt.2013.00077 |pmid=23966955 |pmc=3736117 |issn=1664-0640|doi-access=free }}</ref>
+Addiction is classified as a chronic brain disorder by the [[American Society of Addiction Medicine]] (ASAM).<ref name="Cleveland Clinic" /> There are several reasons why people develop an addiction. A predisposition to the addictive qualities of substances may be inherited by some people, making it a genetic circumstance. Another cause for addictions could be the environment. Whether or not someone develops substance use problems can be influenced by their home and neighborhood, as well as the attitudes of their peers, family, and culture on substance use.<ref name="Cleveland Clinic" /> Another cause of developing an addiction could be related to mental health issues: over 50% of individuals with substance use disorders have experienced mental health issues at some point in their lives. Even moderate substance usage might exacerbate mental health issues in individuals.<ref name="Cleveland Clinic" /> The other view is from the moral standpoint which regards addictive behavior as an intentional choice was freely made by the addict.<ref name="Henden_2013">{{cite journal | vauthors = Henden E, Melberg HO, Røgeberg OJ | title = Addiction: choice or compulsion? | journal = Frontiers in Psychiatry | volume = 4 | pages = 77 | date = 2013 | pmid = 23966955 | pmc = 3736117 | doi = 10.3389/fpsyt.2013.00077 | doi-access = free }}</ref>
 == How addiction affects the brain ==
-Brain imaging techniques have assisted in mapping neural circuits involved in addictive behaviors, such as reward responses, cravings, cue conditioning, and withdrawal symptoms. This has provided key insights on the underlying mechanisms of addiction, including substance use and non-substance (behavioral) addictions<ref name=":12">{{Cite journal |last=Volkow |first=Nora D. |last2=Boyle |first2=Maureen |date=2018-04-25 |title=Neuroscience of Addiction: Relevance to Prevention and Treatment |url=https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2018.17101174 |journal=American Journal of Psychiatry |volume=175 |issue=8 |pages=729–740 |doi=10.1176/appi.ajp.2018.17101174 |issn=0002-953X}}</ref>.
+Brain imaging techniques have assisted in mapping neural circuits involved in addictive behaviors, such as reward responses, cravings, cue conditioning, and withdrawal symptoms. This has provided key insights on the underlying mechanisms of addiction, including substance use and non-substance (behavioral) addictions.<ref name="Volkow_2018">{{cite journal | vauthors = Volkow ND, Boyle M | title = Neuroscience of Addiction: Relevance to Prevention and Treatment | journal = The American Journal of Psychiatry | volume = 175 | issue = 8 | pages = 729–740 | date = August 2018 | pmid = 29690790 | doi = 10.1176/appi.ajp.2018.17101174 }}</ref>
-Addiction hijacks the brain’s [[reward system]], which normally encourages individuals to engage in survival-related activities such as socializing, eating, or achieving goals. Substances or specific behavioral activities create an intense “high” by flooding the reward system with dopamine, a chemical commonly known as “a feel-good chemical". Over time, the brain adapts to this surge by dampening its dopamine production and sensitivity to rewards. Consequently, the addicted individual may experience feelings of sluggishness and lack of motivation unless they consume the substance or engage in an activity to attain a sense of normalcy. This cycle of intense pleasure is followed by withdrawal symptoms and cravings, which fuel addiction<ref>{{Cite journal |last=MacNicol |first=Brent |date=2017-11-11 |title=The biology of addiction |url=https://doi.org/10.1007/s12630-016-0771-2 |journal=Canadian Journal of Anesthesia/Journal canadien d'anesthésie |language=en |volume=64 |issue=2 |pages=141–148 |doi=10.1007/s12630-016-0771-2 |issn=1496-8975 |via=Springer Link}}</ref><ref name=":12" />.
+Addiction hijacks the brain’s [[reward system]], which normally encourages individuals to engage in survival-related activities such as socializing, eating, or achieving goals. Substances or specific behavioral activities create an intense “high” by flooding the reward system with dopamine, a chemical commonly known as “a feel-good chemical". Over time, the brain adapts to this surge by dampening its dopamine production and sensitivity to rewards. Consequently, the addicted individual may experience feelings of sluggishness and lack of motivation unless they consume the substance or engage in an activity to attain a sense of normalcy. This cycle of intense pleasure is followed by withdrawal symptoms and cravings, which fuel addiction.<ref>{{cite journal | vauthors = MacNicol B | title = The biology of addiction | journal = Canadian Journal of Anaesthesia = Journal Canadien d'Anesthesie | volume = 64 | issue = 2 | pages = 141–148 | date = February 2017 | pmid = 27837404 | doi = 10.1007/s12630-016-0771-2 }}</ref><ref name="Volkow_2018" />
-Despite the traditional distinction between substance-use addictions and behavioral addictions, research reveals noteworthy similarities in their [[neurochemical]] mechanisms<ref name=":13">{{Cite journal |last=Potenza |first=Marc N. |date=2006-08-08 |title=Should addictive disorders include non‐substance‐related conditions? |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2006.01591.x |journal=Addiction |language=en |volume=101 |issue=s1 |pages=142–151 |doi=10.1111/j.1360-0443.2006.01591.x |issn=0965-2140 |via=Wiley}}</ref>. Brain imaging studies demonstrates that both types of addiction activate similar regions in the [[Mesolimbic pathway|mesolimbic reward pathway]], a network linked to motivation and pleasure<ref>{{Cite journal |last=Spanagel |first=Rainer |last2=Heilig |first2=Markus |date=2005-11-23 |title=Addiction and its brain science |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2005.01260.x |journal=Addiction |language=en |volume=100 |issue=12 |pages=1813–1822 |doi=10.1111/j.1360-0443.2005.01260.x |issn=0965-2140 |via=Wiley}}</ref>. Moreover, both involve changes in neurotransmitters, such as dopamine and [[serotonin]], which are responsible for regulating mood, impulse control and reward processing. These convergent neurochemical features suggest that substance dependence and non-substance addictions follow similar fundamental stages<ref name=":13" />.
+Despite the traditional distinction between substance-use addictions and behavioral addictions, research reveals noteworthy similarities in their [[neurochemical]] mechanisms.<ref name="Potenza_2006">{{cite journal | vauthors = Potenza MN | title = Should addictive disorders include non-substance-related conditions? | journal = Addiction | volume = 101 | issue = s1 | pages = 142–151 | date = September 2006 | pmid = 16930171 | doi = 10.1111/j.1360-0443.2006.01591.x }}</ref> Brain imaging studies demonstrates that both types of addiction activate similar regions in the [[Mesolimbic pathway|mesolimbic reward pathway]], a network linked to motivation and pleasure.<ref>{{cite journal | vauthors = Spanagel R, Heilig M | title = Addiction and its brain science | journal = Addiction | volume = 100 | issue = 12 | pages = 1813–1822 | date = December 2005 | pmid = 16367982 | doi = 10.1111/j.1360-0443.2005.01260.x }}</ref> Moreover, both involve changes in neurotransmitters, such as dopamine and [[serotonin]], which are responsible for regulating mood, impulse control and reward processing. These convergent neurochemical features suggest that substance dependence and non-substance addictions follow similar fundamental stages.<ref name="Potenza_2006" />
 The key stages of addiction are as follows:
@@ Line 25: / Line 26: @@
 '''Withdrawal:''' Upon cessation of the behavior or the drug effect wearing off, individuals experience negative mood states, including anxiety and anhedonia, due to the dampened reward system. Withdrawal processes are mediated by basal forebrain areas and neurotransmitters such as corticotropin-releasing factor (CRF) and norepinephrine.
-'''Cravings:''' Conditioned cues (sight, smell, and emotions) drive cravings, prompting individuals to seek a re-experience of euphoria. Prefrontal circuits involved in highlighting the substance or addictive behavior’s importance are activated, while the limbic region triggers an automatic response encouraging the pursuit of the activity or substance. Dusyfuntioning in prefrontal cortical regions impairs executive functions, making it difficult to resist craving despite adverse consequences<ref name=":12" />.
+'''Cravings:''' Conditioned cues (sight, smell, and emotions) drive cravings, prompting individuals to seek a re-experience of euphoria. Prefrontal circuits involved in highlighting the substance or addictive behavior’s importance are activated, while the limbic region triggers an automatic response encouraging the pursuit of the activity or substance. Dusyfuntioning in prefrontal cortical regions impairs executive functions, making it difficult to resist craving despite adverse consequences.<ref name="Volkow_2018" />
-These overlapping neurochemical features support the growing understanding of addiction as a border phenomenon, impacting substance-use and behavioral addictions<ref name=":13" />.
+These overlapping neurochemical features support the growing understanding of addiction as a border phenomenon, impacting substance-use and behavioral addictions.<ref name="Potenza_2006" />
 ==Compulsion vs addiction==
-[[Compulsive behaviour|Compulsions]] are the basis of addictions. Reward is one major distinction between compulsion in addicts and compulsion as it is experienced in obsessive-compulsive disorder. An addiction is, by definition, a form of compulsion, and involves [[operant reinforcement]]. For example, dopamine is released in the brain's reward system and is a motive for behaviour (i.e. the compulsions in addiction development through positive reinforcement).<ref>{{Cite journal|last=Solinas|first=Marcello|date=January 30, 2020|title=Dopamine and addiction: What have we learned from 40 years of research.|journal=Journal of Neural Transmission|volume=126|issue=4}}</ref>
+[[Compulsive behaviour|Compulsions]] are the basis of addictions. Reward is one major distinction between compulsion in addicts and compulsion as it is experienced in obsessive-compulsive disorder. An addiction is, by definition, a form of compulsion, and involves [[operant reinforcement]]. For example, dopamine is released in the brain's reward system and is a motive for behaviour (i.e. the compulsions in addiction development through positive reinforcement).<ref>{{cite journal | vauthors = Solinas M, Belujon P, Fernagut PO, Jaber M, Thiriet N | title = Dopamine and addiction: what have we learned from 40 years of research | journal = Journal of Neural Transmission | volume = 126 | issue = 4 | pages = 481–516 | date = April 2019 | pmid = 30569209 }}</ref>
-There are two main differences between compulsion and addiction. Compulsion is the need and desire to do something or carry out a task repetitively or persistently. Whereas addiction is defined by the following step after compulsion where an individual takes action on a compulsion to feel pleasure and satisfaction (the action is known as [[compulsive behaviour|compulsive behavior]]). Notably, for addicts, compulsive behavior can lead to “persistent changes in the brain structures and functions” which creates a cycle of motivation for their behavior that is absent in OCD.<ref name=":0"/>
+There are two main differences between compulsion and addiction. Compulsion is the need and desire to do something or carry out a task repetitively or persistently. Whereas addiction is defined by the following step after compulsion where an individual takes action on a compulsion to feel pleasure and satisfaction (the action is known as [[compulsive behaviour|compulsive behavior]]). Notably, for addicts, compulsive behavior can lead to “persistent changes in the brain structures and functions” which creates a cycle of motivation for their behavior that is absent in OCD.<ref name="Henden_2013"/>
 Compulsions (and compulsive behavior) do not necessarily include pleasure for the individual but addictive behavior does. In contrast, someone who experiences a compulsion as part of obsessive-compulsive disorder may not perceive anything rewarding from acting on the compulsion. Often, it is a way of dealing with the obsessive part of the disorder, resulting in a feeling of relief (i.e., compulsions may also arise through [[negative reinforcement]]).<ref>{{Cite web|title=NIMH » Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over|url=https://www.nimh.nih.gov/health/publications/obsessive-compulsive-disorder-when-unwanted-thoughts-take-over/index.shtml|access-date=2020-10-13|website=www.nimh.nih.gov}}</ref>
 == Correlation between different personality traits and addictive behaviors online ==
-For over a decade, scientists have emphasized that contact with digital technology can potentially lead to addiction. People of all ages utilize digital devices, and their numbers are growing annually. Accordingly, excessive internet use can result in unhealthy internet use, also known as [[Internet addiction disorder|internet addiction]].<ref>{{Cite journal |last=Rachubińska |first=K. |last2=Cybulska |first2=A. |last3=Szkup |first3=M. |last4=Grochans |first4=E. |date=March 2021 |title=Analysis of the relationship between personality traits and Internet addiction |url=https://pubmed.ncbi.nlm.nih.gov/33829445/ |journal=European Review for Medical and Pharmacological Sciences |volume=25 |issue=6 |pages=2591–2599 |doi=10.26355/eurrev_202103_25422 |issn=2284-0729 |pmid=33829445}}</ref>
+For over a decade, scientists have emphasized that contact with digital technology can potentially lead to addiction. People of all ages utilize digital devices, and their numbers are growing annually. Accordingly, excessive internet use can result in unhealthy internet use, also known as [[Internet addiction disorder|internet addiction]].<ref>{{cite journal | vauthors = Rachubińska K, Cybulska A, Szkup M, Grochans E | title = Analysis of the relationship between personality traits and Internet addiction | journal = European Review for Medical and Pharmacological Sciences | volume = 25 | issue = 6 | pages = 2591–2599 | date = March 2021 | pmid = 33829445 | doi = 10.26355/eurrev_202103_25422 }}</ref>
-It's been proven that the [[Big Five personality traits|big five personality traits]] and internet addiction are associated. A recent study aimed to examine the relationships between the big five personality traits and internet addiction within this framework.<ref name=":1">{{Cite journal |last=Kayiş |first=Ahmet Rıfat |last2=Satici |first2=Seydi Ahmet |last3=Yilmaz |first3=Muhammet Fatih |last4=Şimşek |first4=Didem |last5=Ceyhan |first5=Esra |last6=Bakioğlu |first6=Fuad |date=2016-10-01 |title=Big five-personality trait and internet addiction |url=https://doi.org/10.1016/j.chb.2016.05.012 |journal=Computers in Human Behavior |volume=63 |issue=C |pages=35–40 |doi=10.1016/j.chb.2016.05.012 |issn=0747-5632}}</ref> As such, the researchers employed the [[meta-analysis]] method. In accordance with the study's goal, twelve papers were included in the meta-analysis, and thirteen [[effect size]]s were derived from these investigations.<ref name=":1" /> In this case, it was shown that agreeableness, conscientiousness, extraversion, and openness to new experiences were inversely correlated with internet addiction, while neuroticism was positively correlated with it. As a result, it's thought that the big five personality traits play a significant role in the development of an internet addiction.<ref name=":1" />
+It's been proven that the [[Big Five personality traits|big five personality traits]] and internet addiction are associated. A recent study aimed to examine the relationships between the big five personality traits and internet addiction within this framework.<ref name="Kayiş_2016">{{Cite journal | vauthors = Kayiş AR, Satici SA, Yilmaz MF, Şimşek D, Ceyhan E, Bakioğlu F |date=2016-10-01 |title=Big five-personality trait and internet addiction |journal=Computers in Human Behavior |volume=63 |issue=C |pages=35–40 |doi=10.1016/j.chb.2016.05.012 |issn=0747-5632}}</ref> As such, the researchers employed the [[meta-analysis]] method. In accordance with the study's goal, twelve papers were included in the meta-analysis, and thirteen [[effect size]]s were derived from these investigations.<ref name="Kayiş_2016" /> In this case, it was shown that agreeableness, conscientiousness, extraversion, and openness to new experiences were inversely correlated with internet addiction, while neuroticism was positively correlated with it. As a result, it's thought that the big five personality traits play a significant role in the development of an internet addiction.<ref name="Kayiş_2016" />
-Another study focuses on [[neuroticism]], which has been frequently proven to be a risk factor for internet addiction. The following categories  were used to summarize the concepts related to neuroticism and internet addiction: internalizing problems, externalizing problems, coping style, and other factors.<ref name=":9">{{Cite journal |last=Marciano |first=Laura |last2=Camerini |first2=Anne-Linda |last3=Schulz |first3=Peter J. |date=2022-02-01 |title=Neuroticism and internet addiction: What is next? A systematic conceptual review |url=https://www.sciencedirect.com/science/article/pii/S0191886921006395 |journal=Personality and Individual Differences |volume=185 |pages=111260 |doi=10.1016/j.paid.2021.111260 |issn=0191-8869|doi-access=free }}</ref> The most significant finding from the study is that, with rare exceptions, internet addiction has been primarily included as an outcome and all other ideas as predictors.<ref name=":9" /> Internalizing problems comprise the most consistent subset of the topics in the study. In addition to having a positive correlation, neuroticism and internalizing problems were independent predictors of internet, smartphone, and social media addiction. Regarding externalizing problems—which were often the subject of less research—the same picture became apparent.<ref name=":9" /> The review's findings also demonstrated that, similar to neurotic people's difficulties with emotion regulation, the internet provides them with a special setting in which to deal with unpleasant emotions. Furthermore, having poor-quality social relationships increases the risk of developing internet addiction and other digital addictions, particularly in those with high levels of neuroticism.<ref name=":9" />
+Another study focuses on [[neuroticism]], which has been frequently proven to be a risk factor for internet addiction. The following categories  were used to summarize the concepts related to neuroticism and internet addiction: internalizing problems, externalizing problems, coping style, and other factors.<ref name="Marciano_2022">{{Cite journal | vauthors = Marciano L, Camerini AL, Schulz PJ |date= February 2022 |title=Neuroticism and internet addiction: What is next? A systematic conceptual review |journal=Personality and Individual Differences |volume=185 |pages=111260 |doi=10.1016/j.paid.2021.111260 |issn=0191-8869|doi-access=free }}</ref> The most significant finding from the study is that, with rare exceptions, internet addiction has been primarily included as an outcome and all other ideas as predictors.<ref name="Marciano_2022" /> Internalizing problems comprise the most consistent subset of the topics in the study. In addition to having a positive correlation, neuroticism and internalizing problems were independent predictors of internet, smartphone, and social media addiction. Regarding externalizing problems—which were often the subject of less research—the same picture became apparent.<ref name="Marciano_2022" /> The review's findings also demonstrated that, similar to neurotic people's difficulties with emotion regulation, the internet provides them with a special setting in which to deal with unpleasant emotions. Furthermore, having poor-quality social relationships increases the risk of developing internet addiction and other digital addictions, particularly in those with high levels of neuroticism.<ref name="Marciano_2022" />
 == Development of addictive behaviors in adolescents ==
-Given the similarities between substance use addictions and behavioral addictions, the risk factors for susceptibility appear similar, with age of onset (adolescence) being a key factor<ref name=":14" />. [[Adolescence]] is a period of time characterized by significant changes of physical, cognitive and emotional nature.<ref name=":10">{{Cite journal |last=Tzavela |first=Eleni C. |last4=Mavromati |first4=Foteini |last5= |first5= |last6= |first6= |last7= |first7= |last8= |first8= |last9= |first9= |last10= |first10= |date=2013 |title=Online social networking in adolescence: Associations with development, well-being and internet addictive behaviors. |url= |journal=International Journal of Adolescence |volume=6 |issue=4 |pages=411–420 |doi= |issn=1939-5930}}</ref> Adolescents are discovering their individuality and struggle to balance their independence with peer [[conformity]].<ref name=":10" /> During this transitional period, adolescents are therefore vulnerable to developing addictive behaviors.
+Given the similarities between substance use addictions and behavioral addictions, the risk factors for susceptibility appear similar, with age of onset (adolescence) being a key factor.<ref name="Winters_2011" /> [[Adolescence]] is a period of time characterized by significant changes of physical, cognitive and emotional nature.<ref name="Tzavela_2013">{{Cite journal | vauthors = Tzavela EC, Mavromati FM |date=2013 |title=Online social networking in adolescence: Associations with development, well-being and internet addictive behaviors. |url= |journal=International Journal of Adolescence |volume=6 |issue=4 |pages=411–420 |doi= |issn=1939-5930}}</ref> Adolescents are discovering their individuality and struggle to balance their independence with peer [[conformity]].<ref name="Tzavela_2013" /> During this transitional period, adolescents are therefore vulnerable to developing addictive behaviors.
-Epidemiological studies reveal that recreational users differentiate from those with substance use disorders. Research suggests a correlation between individuals who initiate substance use during adolescence and developing a substance use addiction, progressing rapidly from trial to the adverse consequences of addiction. Substance usage increases in late adolescence and young adulthood, with alcohol, marijuana, and tobacco being the most widely consumed substances<ref name=":14">{{Cite journal |last=Winters |first=Ken C. |last2=Arria |first2=Amelia |date=2011 |title=Adolescent Brain Development and Drugs |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399589/ |journal=The prevention researcher |volume=18 |issue=2 |pages=21–24 |issn=1086-4385 |pmc=3399589 |pmid=22822298 |via=PubMed Central}}</ref>.
+Epidemiological studies reveal that recreational users differentiate from those with substance use disorders. Research suggests a correlation between individuals who initiate substance use during adolescence and developing a substance use addiction, progressing rapidly from trial to the adverse consequences of addiction. Substance usage increases in late adolescence and young adulthood, with alcohol, marijuana, and tobacco being the most widely consumed substances.<ref name="Winters_2011">{{cite journal | vauthors = Winters KC, Arria A | title = Adolescent Brain Development and Drugs | journal = The Prevention Researcher | volume = 18 | issue = 2 | pages = 21–24 | date = 2011 | pmid = 22822298 | pmc = 3399589 }}</ref>
-Brain maturation during adolescence is more susceptible to developing addictive behaviors as it further promotes risk-taking behaviors and subsequently early addiction decisions<ref>{{Cite journal |last=Nawi |first=Azmawati Mohammed |last2=Ismail |first2=Rozmi |last3=Ibrahim |first3=Fauziah |last4=Hassan |first4=Mohd Rohaizat |last5=Manaf |first5=Mohd Rizal Abdul |last6=Amit |first6=Noh |last7=Ibrahim |first7=Norhayati |last8=Shafurdin |first8=Nurul Shafini |date=2021-11-13 |title=Risk and protective factors of drug abuse among adolescents: a systematic review |url=https://doi.org/10.1186/s12889-021-11906-2 |journal=BMC Public Health |volume=21 |issue=1 |pages=2088 |doi=10.1186/s12889-021-11906-2 |issn=1471-2458 |pmc=8590764 |pmid=34774013 |via=BMC Public Health}}</ref>. This has been corroborated by animal studies, revealing that biological factors may desensitize adolescents to the sedative effects of chemical substances, such as alcohol, leading to increased consumption during the teenage years<ref>{{Cite journal |last=Schramm-Sapyta |first=Nicole L. |last2=Walker |first2=Q. David |last3=Caster |first3=Joseph M. |last4=Levin |first4=Edward D. |last5=Kuhn |first5=Cynthia M. |date=2009-06-23 |title=Are adolescents more vulnerable to drug addiction than adults? Evidence from animal models |url=http://link.springer.com/10.1007/s00213-009-1585-5 |journal=Psychopharmacology |language=en |volume=206 |issue=1 |pages=1–21 |doi=10.1007/s00213-009-1585-5 |issn=0033-3158 |pmc=3025448 |pmid=19547960}}</ref>. In fact, drug or alcohol-induced addictive behaviors in adolescents have been linked to models discussing a stronger sensitization of the appetitive response and disrupted inhibitory control.<ref name=":2">{{Cite journal |last1=Wiers |first1=Reinout W. |last2=Bartholow |first2=Bruce D. |last3=van den Wildenberg |first3=Esther |last4=Thush |first4=Carolien |last5=Engels |first5=Rutger C.M.E. |last6=Sher |first6=Kenneth J. |last7=Grenard |first7=Jerry |last8=Ames |first8=Susan L. |last9=Stacy |first9=Alan W. |date=February 2007 |title=Automatic and controlled processes and the development of addictive behaviors in adolescents: A review and a model |url=http://dx.doi.org/10.1016/j.pbb.2006.09.021 |journal=Pharmacology Biochemistry and Behavior |volume=86 |issue=2 |pages=263–283 |doi=10.1016/j.pbb.2006.09.021 |issn=0091-3057 |pmid=17116324 |s2cid=18979706}}</ref> Moreover, the susceptibility of adolescents is heightened as they tend to weigh the rewarding effects of the activity or stimulus more heavily than the negative effects, while also being less sensitive to withdrawal effects. In early adolescence, individuals lack the motivation to control appetitive motivational tendencies.<ref name=":2" /> The presence of positive and negative [[Reinforcement|reinforcers]] seem to increase alcohol consumption, portraying a positive correlation between motives and alcohol consumption.<ref name=":2" /> After initiating drinking, there seems to be an increase in appetitive motivation to drink and a negative effect on controlled regulatory processes.<ref name=":2" /> The imbalance between these factors lead to increased substance use.<ref name=":2" />  Although there have been declines in adolescent substance use rates, trends of rising e-cigarette (vape) usage highlight the ongoing health care concern regarding adolescent substance use and its effects on neurodevelopment processes during this crucial developmental stage<ref>{{Cite journal |last=Hamidullah |first=Shahnaza |last2=Thorpe |first2=Hayley H. A. |last3=Frie |first3=Jude A. |last4=Mccurdy |first4=Richard D. |last5=Khokhar |first5=Jibran Y. |date=2020-08-04 |title=Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates |url=https://www.frontiersin.org/articles/10.3389/fnhum.2020.00298 |journal=Frontiers in Human Neuroscience |volume=14 |doi=10.3389/fnhum.2020.00298 |issn=1662-5161 |pmc=7418456 |pmid=32848673 |via=Frontiers}}</ref>.
+Brain maturation during adolescence is more susceptible to developing addictive behaviors as it further promotes risk-taking behaviors and subsequently early addiction decisions.<ref>{{cite journal | vauthors = Nawi AM, Ismail R, Ibrahim F, Hassan MR, Manaf MR, Amit N, Ibrahim N, Shafurdin NS | title = Risk and protective factors of drug abuse among adolescents: a systematic review | journal = BMC Public Health | volume = 21 | issue = 1 | pages = 2088 | date = November 2021 | pmid = 34774013 | pmc = 8590764 | doi = 10.1186/s12889-021-11906-2 }}</ref> This has been corroborated by animal studies, revealing that biological factors may desensitize adolescents to the sedative effects of chemical substances, such as alcohol, leading to increased consumption during the teenage years,<ref>{{cite journal | vauthors = Schramm-Sapyta NL, Walker QD, Caster JM, Levin ED, Kuhn CM | title = Are adolescents more vulnerable to drug addiction than adults? Evidence from animal models | journal = Psychopharmacology | volume = 206 | issue = 1 | pages = 1–21 | date = September 2009 | pmid = 19547960 | pmc = 3025448 | doi = 10.1007/s00213-009-1585-5 }}</ref> In fact, drug or alcohol-induced addictive behaviors in adolescents have been linked to models discussing a stronger sensitization of the appetitive response and disrupted inhibitory control.<ref name="Wiers_2007">{{cite journal | vauthors = Wiers RW, Bartholow BD, van den Wildenberg E, Thush C, Engels RC, Sher KJ, Grenard J, Ames SL, Stacy AW | title = Automatic and controlled processes and the development of addictive behaviors in adolescents: a review and a model | journal = Pharmacology, Biochemistry, and Behavior | volume = 86 | issue = 2 | pages = 263–283 | date = February 2007 | pmid = 17116324 | doi = 10.1016/j.pbb.2006.09.021 | s2cid = 18979706 }}</ref> Moreover, the susceptibility of adolescents is heightened as they tend to weigh the rewarding effects of the activity or stimulus more heavily than the negative effects, while also being less sensitive to withdrawal effects. In early adolescence, individuals lack the motivation to control appetitive motivational tendencies.<ref name="Wiers_2007" /> The presence of positive and negative [[Reinforcement|reinforcers]] seem to increase alcohol consumption, portraying a positive correlation between motives and alcohol consumption.<ref name="Wiers_2007" /> After initiating drinking, there seems to be an increase in appetitive motivation to drink and a negative effect on controlled regulatory processes.<ref name="Wiers_2007" /> The imbalance between these factors lead to increased substance use.<ref name="Wiers_2007" />  Although there have been declines in adolescent substance use rates, trends of rising e-cigarette (vape) usage highlight the ongoing health care concern regarding adolescent substance use and its effects on neurodevelopment processes during this crucial developmental stage.<ref>{{cite journal | vauthors = Hamidullah S, Thorpe HH, Frie JA, Mccurdy RD, Khokhar JY | title = Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates | journal = Frontiers in Human Neuroscience | volume = 14 | pages = 298 | date = 2020-08-04 | pmid = 32848673 | pmc = 7418456 | doi = 10.3389/fnhum.2020.00298 }}</ref>
-In addition to the environmental influences, there seems to be a genetic role in adolescent addictive behaviors. Addiction risk alleles can increase the risk of addictive behaviors in teens.<ref>{{Cite journal |last=Blum |first=Kenneth |last2=Febo |first2=Marcelo |last3=Smith |first3=David E. |last4=Roy |first4=A. Kenison |last5=Demetrovics |first5=Zsolt |last6=Cronjé |first6=Frans J. |last7=Femino |first7=John |last8=Agan |first8=Gozde |last9=Fratantonio |first9=James L. |last10=Pandey |first10=Subhash C. |last11=Badgaiyan |first11=Rajendra D. |last12=Gold |first12=Mark S. |date=2015-05-01 |title=Neurogenetic and Epigenetic Correlates of Adolescent Predisposition to and Risk for Addictive Behaviors as a Function of Prefrontal Cortex Dysregulation |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442554/ |journal=Journal of Child and Adolescent Psychopharmacology |volume=25 |issue=4 |pages=286–292 |doi=10.1089/cap.2014.0146 |issn=1044-5463 |pmc=4442554 |pmid=25919973}}</ref>  Furthermore, the [[prefrontal cortex]], the region responsible for decision making and executive function, is still developing during adolescence.<ref name=":6">{{Cite journal |last=Hammond |first=Christopher J. |last2=Mayes |first2=Linda C. |last3=Potenza |first3=Marc N. |date=April 2014 |title=Neurobiology of Adolescent Substance Use and Addictive Behaviors: Prevention and Treatment Implications |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446977/ |journal=Adolescent medicine: state of the art reviews |volume=25 |issue=1 |pages=15–32 |issn=1934-4287 |pmc=4446977 |pmid=25022184}}</ref> This creates a vulnerability and the initiation of addictive behavior during this developmental stage can thus affect long-term functioning.<ref name=":6" />
+In addition to the environmental influences, there seems to be a genetic role in adolescent addictive behaviors. Addiction risk alleles can increase the risk of addictive behaviors in teens.<ref>{{cite journal | vauthors = Blum K, Febo M, Smith DE, Roy AK, Demetrovics Z, Cronjé FJ, Femino J, Agan G, Fratantonio JL, Pandey SC, Badgaiyan RD, Gold MS | title = Neurogenetic and epigenetic correlates of adolescent predisposition to and risk for addictive behaviors as a function of prefrontal cortex dysregulation | journal = Journal of Child and Adolescent Psychopharmacology | volume = 25 | issue = 4 | pages = 286–292 | date = May 2015 | pmid = 25919973 | pmc = 4442554 | doi = 10.1089/cap.2014.0146 }}</ref>  Furthermore, the [[prefrontal cortex]], the region responsible for decision making and executive function, is still developing during adolescence.<ref name="Hammond_2014">{{cite journal | vauthors = Hammond CJ, Mayes LC, Potenza MN | title = Neurobiology of adolescent substance use and addictive behaviors: treatment implications | journal = Adolescent Medicine | volume = 25 | issue = 1 | pages = 15–32 | date = April 2014 | pmid = 25022184 | pmc = 4446977 }}</ref> This creates a vulnerability and the initiation of addictive behavior during this developmental stage can thus affect long-term functioning.<ref name="Hammond_2014" />
 == Therapy for addictions ==
-Therapy for addictions is not a cure, but a way of managing addictive behaviors.<ref name=":7">{{Cite web |title=Treatment and Recovery I National Institute on Drug Abuse (NIDA) |url=https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery |access-date=2023-11-13 |website=nida.nih.gov |language=en}}</ref> It is a treatment tailored to the specific triggers and root causes affecting each patient (such as trauma, stress, or anxiety),<ref name=":3">{{Citation |last=Chabert |first=Catherine |title=Obsessions, addictions, compulsions : contraintes narcissiques et fantasme d'inceste |date=2015-03-04 |url=http://dx.doi.org/10.3917/puf.andre.2015.03.0019 |work=Les travaux forcés de la répétition |pages=19–40 |access-date=2022-04-22 |series=Petite bibliothèque de psychanalyse |publisher=Presses Universitaires de France |doi=10.3917/puf.andre.2015.03.0019 |isbn=9782130653455}}</ref> and that "enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives."<ref name=":7" />
+Therapy for addictions is not a cure, but a way of managing addictive behaviors.<ref name="nida.nih.gov">{{Cite web |title=Treatment and Recovery I National Institute on Drug Abuse (NIDA) |url=https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery |access-date=2023-11-13 |website=nida.nih.gov |language=en}}</ref> It is a treatment tailored to the specific triggers and root causes affecting each patient (such as trauma, stress, or anxiety),<ref name="Chabert_2015">{{Citation |last=Chabert |first=Catherine |title=Obsessions, addictions, compulsions : contraintes narcissiques et fantasme d'inceste |date=2015-03-04 |url=http://dx.doi.org/10.3917/puf.andre.2015.03.0019 |work=Les travaux forcés de la répétition |pages=19–40 |access-date=2022-04-22 |series=Petite bibliothèque de psychanalyse |publisher=Presses Universitaires de France |doi=10.3917/puf.andre.2015.03.0019 |isbn=9782130653455}}</ref> and that "enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives."<ref name="nida.nih.gov" />
-Various therapeutic approaches exist to assist individuals in modifying addictive behaviors (i.e.: such as [[Yoga as therapy|yoga therapy]], which can “treat or prevent addiction”),.<ref>{{Cite journal |last=Khanna |first=Surbhi |last2=Greeson |first2=Jeffrey M. |date=2013-06-01 |title=A narrative review of yoga and mindfulness as complementary therapies for addiction |url=https://www.sciencedirect.com/science/article/pii/S0965229913000265 |journal=Complementary Therapies in Medicine |volume=21 |issue=3 |pages=244–252 |doi=10.1016/j.ctim.2013.01.008 |issn=0965-2299}}</ref> However, individuals seeking therapy for addictive behaviors may benefit significantly from consulting with a therapist recognized by medical institutions for their expertise in addiction or compulsion.<ref name=":3" />
+Various therapeutic approaches exist to assist individuals in modifying addictive behaviors (i.e.: such as [[Yoga as therapy|yoga therapy]], which can “treat or prevent addiction”),.<ref>{{cite journal | vauthors = Khanna S, Greeson JM | title = A narrative review of yoga and mindfulness as complementary therapies for addiction | journal = Complementary Therapies in Medicine | volume = 21 | issue = 3 | pages = 244–252 | date = June 2013 | pmid = 23642957 | doi = 10.1016/j.ctim.2013.01.008 }}</ref> However, individuals seeking therapy for addictive behaviors may benefit significantly from consulting with a therapist recognized by medical institutions for their expertise in addiction or compulsion.<ref name="Chabert_2015" />
-While medical interventions may be necessary for physical detoxification in certain cases, “addiction therapy or addiction counseling is focused on treating psychological addiction”.<ref name=":8">{{Cite web |title=Addiction Counselling |url=https://www.fireflycounselling.ca/edmonton-addiction-and-substance-abuse-therapy |access-date=2023-11-13 |website=Psychology Edmonton Psychology - Firefly Counselling |language=en-CA}}</ref> For instance, individuals may engage in addictive behaviors to cope with “historical trauma”, necessitating a therapist to use trauma focused cognitive behavioral therapy or [[exposure therapy]] to address past issues.<ref name=":8" /> Alternatively, for those using addictive behaviors to cope with current events, therapy addiction may focus on “learning stress management techniques and emotional regulation skills”, including cognitive behavioral therapy or acceptance and commitment therapy.<ref name=":8" /> In other cases, when addiction is intertwined with [[Mental disorder|mental health issues]], therapists employ an integrated approach, addressing conditions (i.e.: depression, anxiety, or bipolar disorder) alongside the addiction through procedures such as dialectical behavior therapy or [[hypnotherapy]].<ref name=":8" />
+While medical interventions may be necessary for physical detoxification in certain cases, “addiction therapy or addiction counseling is focused on treating psychological addiction”.<ref name="Psychology Edmonton Psychology - Firefly Counselling">{{Cite web |title=Addiction Counselling |url=https://www.fireflycounselling.ca/edmonton-addiction-and-substance-abuse-therapy |access-date=2023-11-13 |website=Psychology Edmonton Psychology - Firefly Counselling |language=en-CA}}</ref> For instance, individuals may engage in addictive behaviors to cope with “historical trauma”, necessitating a therapist to use trauma focused cognitive behavioral therapy or [[exposure therapy]] to address past issues.<ref name="Psychology Edmonton Psychology - Firefly Counselling" /> Alternatively, for those using addictive behaviors to cope with current events, therapy addiction may focus on “learning stress management techniques and emotional regulation skills”, including cognitive behavioral therapy or acceptance and commitment therapy.<ref name="Psychology Edmonton Psychology - Firefly Counselling" /> In other cases, when addiction is intertwined with [[Mental disorder|mental health issues]], therapists employ an integrated approach, addressing conditions (i.e.: depression, anxiety, or bipolar disorder) alongside the addiction through procedures such as dialectical behavior therapy or [[hypnotherapy]].<ref name="Psychology Edmonton Psychology - Firefly Counselling" />
 The use of these treatments is increasing in the medical field, as “a shift is occurring to mainstream the delivery of early intervention and treatment services into general health care practice”.<ref>{{Citation |title=Early Intervention, Treatment, and Management of Substance Use Disorders |url=https://www.ncbi.nlm.nih.gov/books/NBK424859/ |work=Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health |access-date=2023-11-13 |publisher=US Department of Health and Human Services |language=en}}</ref>