Chambers R Andrew, Potenza Marc N
Yale University School of Medicine, USA.
J Gambl Stud. 2003 Spring;19(1):53-84. doi: 10.1023/a:1021275130071.
The prevalence of problem and pathological gambling in adolescence and young adulthood has been found to be two- to fourfold higher than in adulthood. Given that these high rates might predict future increases across all age groups, it is important to explore the causes of the elevated rates of problem and pathological gambling among youths. This article reviews evidence for a neurobiological basis for adolescent vulnerability to problem and pathological gambling behaviors. We propose that a common trait motif of impulsivity might underlie phenomenology of pathological gambling, commonly comorbid psychiatric disorders, and related aspects of adolescent behavior. Recent advances in understanding the brain mechanisms involved in motivation, reward, and decision-making allow a discussion of neural circuitry underlying impulsivity. Emerging data indicate that important neurodevelopmental events during adolescence occur in brain regions associated with motivation and impulsive behavior. We hypothesize that immaturity of frontal cortical and subcortical monoaminergic systems during normal neurodevelopment underlies adolescent impulsivity as a transitional trait-behavior. While these neurodevelopmental processes may confer advantage by promoting a learning drive for optimal adaptation to adult roles, they may also confer an increased vulnerability to addictive behaviors such as problem and pathological gambling. An exploration of the developmental changes in neural circuitry involved in impulse control has significant implications for understanding adolescent behaviors and treating problem and pathological gambling among youths.
研究发现,青少年和青年期问题赌博及病态赌博的患病率比成年期高出两到四倍。鉴于这些高患病率可能预示着所有年龄组未来患病率的上升,探究青少年中问题赌博及病态赌博患病率升高的原因非常重要。本文综述了青少年易患问题赌博及病态赌博行为的神经生物学基础的证据。我们认为,冲动性这一共同特征可能是病态赌博现象学、常见共病精神障碍以及青少年行为相关方面的基础。在理解动机、奖励和决策所涉及的脑机制方面的最新进展,使得人们能够讨论冲动性背后的神经回路。新出现的数据表明,青少年时期重要的神经发育事件发生在与动机和冲动行为相关的脑区。我们假设,在正常神经发育过程中,额叶皮质和皮质下单胺能系统的不成熟是青少年冲动性这一过渡性特质行为的基础。虽然这些神经发育过程可能通过促进对成人角色的最佳适应的学习驱动力而带来优势,但它们也可能增加对成瘾行为(如问题赌博和病态赌博)的易感性。探索参与冲动控制的神经回路的发育变化,对于理解青少年行为以及治疗青少年的问题赌博和病态赌博具有重要意义。