Potenza Marc N
Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, Room S-104, 34 Park Street, New Haven, CT 06519, USA.
Philos Trans R Soc Lond B Biol Sci. 2008 Oct 12;363(1507):3181-9. doi: 10.1098/rstb.2008.0100.
Gambling is a prevalent recreational behaviour. Approximately 5% of adults have been estimated to experience problems with gambling. The most severe form of gambling, pathological gambling (PG), is recognized as a mental health condition. Two alternate non-mutually exclusive conceptualizations of PG have considered it as an obsessive-compulsive spectrum disorder and a 'behavioural' addiction. The most appropriate conceptualization of PG has important theoretical and practical implications. Data suggest a closer relationship between PG and substance use disorders than exists between PG and obsessive-compulsive disorder. This paper will review data on the neurobiology of PG, consider its conceptualization as a behavioural addiction, discuss impulsivity as an underlying construct, and present new brain imaging findings investigating the neural correlates of craving states in PG as compared to those in cocaine dependence. Implications for prevention and treatment strategies will be discussed.
赌博是一种普遍的娱乐行为。据估计,约5%的成年人存在赌博问题。赌博最严重的形式,即病态赌博(PG),被视为一种心理健康状况。PG有两种相互不排斥的替代概念化方式,一种将其视为强迫症谱系障碍,另一种将其视为“行为”成瘾。PG最合适的概念化方式具有重要的理论和实践意义。数据表明,PG与物质使用障碍之间的关系比PG与强迫症之间的关系更为密切。本文将回顾PG神经生物学的数据,考虑将其概念化为行为成瘾,讨论冲动性这一潜在结构,并展示新的脑成像研究结果,该研究调查了PG与可卡因依赖中渴望状态的神经关联。还将讨论对预防和治疗策略的影响。