However, a paradigm shift in understanding addiction is in motion.
Take sex addiction. Seeking treatment for this controversial condition has, in cases such as that of the golfer Tiger Woods, been criticised as a cynical shortcut to redemption for philanderers. On the other hand, neuroscientists who have been able to study the brains of people with debilitatingly compulsive obsessions with sex witness similar responses to those they have observed in drug addiction cases.
Terry Robinson, an esteemed professor of psychology and neuroscience at the University of Michigan — together with his colleague, Kent Berridge — identified dopamine as the neurochemical responsible for craving.
He thinks debating the semantics of addiction is unhelpful. There are certainly similarities in terms of the psychological and neurobiological mechanisms involved. The first factor is that our modern environment is stuffed with craving-inducing stimuli.
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Our liking of sweet tastes suited us when we were hunter-gatherers, helping us choose ripe energy sources. Now, we have high-fructose corn syrup, which blows our minds with unnatural levels of glucose. The pharmacology is different and this can also increase propensity to addiction. His final factor is simply access. Does this mean that more people are at risk in this era of throbbing dopamine excitation? Another theory about what is driving the diversification of addictive behaviours stems from a series of experiments conducted in Canada in the late s known as Rat Park.
The context was driving addiction, rather than the drug itself. The resulting study made minimal waves when it was published — yet today, Alexander is being flown all over the world to share his take on addiction, which he calls the dislocation theory. However, updates to diagnosis guidelines mean that people who sit lower on the addictive spectrum can now be seen as having problematic dependencies. Perhaps as many as one in four males would meet the criteria for alcohol dependency, and a lower, but still substantial, number of females.
Assistance can also come in the form of stimulus-control tools. Mindfulness meditation has also helped to reduce substance abuse.
In fact, it was found to be more effective than the Alcoholics Anonymous step programme and CBT in research led by Sarah Bowden, an assistant professor of clinical psychology at Pacific University in Portland, Oregon; the previous year, Bowden, Berridge and other neuroscientific luminaries met to discuss addiction with the Dalai Lama. After all, Buddhists caught on to this craving problem thousands of years ago, using meditation to overcome the very urges that they identified as the linchpin of human suffering, long before these dopamine-fuelled times.
After undergoing evaluations to establish how much they gambled, the volunteers were asked to lie inside a functional magnetic resonance imaging fMRI scanner that recorded brain activity during a task that required them to push a button as quickly as possible in order to win money or to see sexy pictures of women.
The faster participants pushed the button, the more motivated they were thought to be to get the reward. This experimental paradigm is more objective than a questionnaire and has been extensively tested in humans and animal models, Sescousse says. Prior to the task, the majority of gamblers reported that they valued money and sex equally. Their results, however, showed an unconscious bent toward cash. As the participants performed the task, the researchers watched their brain responses on the fMRI scanner, which tracks blood flow as a measure of brain activity.
They found that gamblers had much diminished responses to erotic images compared with monetary images in the ventral striatum, a brain region that processes reward. The difference in response was much smaller in controls, Sescousse says. Next, the researchers looked at the participants' brain activity in another key brain region involved in reward, the orbitofrontal cortex.
In previous studies of healthy people, they had noticed that different parts of the orbitofrontal cortex respond to erotic and monetary stimuli—a division they think reflects a dissociation between innate rewards such as food and sex, which are key to survival, and secondary rewards such as money and power, which we must learn to value.
In compulsive gamblers, the same region that normally only lights up in response to sex was activated when the participants looked at monetary cues, suggesting that they interpreted money as a more primary reward, the researchers say. Cognitive therapies that enhance sensitivity to nonmonetary rewards and change how gamblers think about money—for example to think of it as a tool, rather than as a reward in itself—might help address this distortion, Sescousse says. It's possible that the gamblers' sensitivity to rewarding activities such as sex may be so blunted that gambling is the only thing that still brings pleasure, he says.
By Kai Kupferschmidt Jun. By Jeffrey Mervis Jun.
By Jeffrey Brainard Jun. By Katie Camero , Sabine Galvis , et al.
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Mind on money. Money is more motivating to gamblers than pictures of sex.