|Addiction and dependence glossary|
|• addiction – a state characterized by compulsive engagement in rewarding stimuli despite adverse consequences|
|• reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them|
|• rewarding stimuli – stimuli that the brain interprets as intrinsically positive or as something to be approached|
|• addictive drug – a drug that is both rewarding and reinforcing|
|• addictive behavior – a behavior that is both rewarding and reinforcing|
|• sensitization – an amplified response to a stimulus resulting from repeated exposure to it|
|• tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose|
|• drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose|
|• dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)|
|• physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens)|
|• psychological dependence – dependence that involves emotional–motivational withdrawal symptoms (e.g., dysphoria and anhedonia)|
|(edit | history)|
Psychological dependence is a form of dependence that involves emotional–motivational withdrawal symptoms (e.g., a state of unease or dissatisfaction, a reduced capacity to experience pleasure, or anxiety) upon cessation of drug use or engagement in certain behaviors. Physical and psychological dependence are sometimes classified as a facet or component of addiction, such as in the DSM-IV-TR; however, some drugs which produce dependence syndromes do not produce addiction, and vice versa, in humans. Addiction and psychological dependence are both mediated through psychological reinforcement, a form of operant conditioning, but are associated with different forms of reinforcement. Addiction is a compulsion for rewarding stimuli that is mediated through positive reinforcement. Psychological dependence, which is mediated through negative reinforcement, involves a desire to use a drug or perform a behavior to avoid the unpleasant withdrawal syndrome that results from cessation of exposure to it.
Psychological dependence develops through consistent and frequent exposure to a stimulus. Behaviors which can produce observable psychological withdrawal symptoms (i.e., cause psychological dependence) include physical exercise, shopping, sex and self-stimulation using pornography, and eating food with high sugar or fat content, among others. Behavioral therapy is typically employed to help individuals overcome psychological dependence upon drugs or maladaptive behaviors that produce psychological dependence.
- Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 364–375. ISBN 9780071481274.
- Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues Clin. Neurosci. 15 (4): 431–443. PMC 3898681. PMID 24459410.
- "Glossary of Terms". Mount Sinai School of Medicine. Department of Neuroscience. Retrieved 9 February 2015.
- Olsen CM (December 2011). "Natural rewards, neuroplasticity, and non-drug addictions". Neuropharmacology 61 (7): 1109–1122. doi:10.1016/j.neuropharm.2011.03.010. PMC 3139704. PMID 21459101.
- Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 364–368. ISBN 9780071481274.
The defining feature of addiction is compulsive, out-of-control drug use, despite negative consequences. ...
Addictive drugs are both rewarding and reinforcing. ... Familiar pharmacologic terms such as tolerance, dependence, and sensitization are useful in describing some of the time-dependent processes that underlie addiction. ...
Dependence is defined as an adaptive state that develops in response to repeated drug administration, and is unmasked during withdrawal, which occurs when drug taking stops. Dependence from long-term drug use may have both a somatic component, manifested by physical symptoms, and an emotional–motivation component, manifested by dysphoria. While physical dependence and withdrawal occur with some drugs of abuse (opiates, ethanol), these phenomena are not useful in the diagnosis of addiction because they do not occur with other drugs of abuse (cocaine, amphetamine) and can occur with many drugs that are not abused (propranolol, clonidine).
The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders (2000), which makes distinctions between drug use, abuse, and substance dependence, is flawed. First, diagnosis of drug use versus abuse can be arbitrary and reflect cultural norms, not medical phenomena. Second, the term substance dependence implies that dependence is the primary pharmacologic phenomenon underlying addiction, which is likely not true, as tolerance, sensitization, and learning and memory also play central roles. It is ironic and unfortunate that the Manual avoids use of the term addiction, which provides the best description of the clinical syndrome.
- Hanson, Glen, Peter J. Venturelli, and Annette E. Fleckenstein. Drugs and Society. Sudbury, MA: Jones and Bartlett, 2009. Print.
- "Psychological Dependence". Retrieved 2 December 2010.
- The national center on addiction and substance abuse at Columbia University:"Wasting the Best and the Brightest: Substance Abuse at America’s Colleges and Universities", march 2007, also published on http://www.casacolumbia.org/templates/publications_reports.aspx?keywords=psychological+dependence