Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Can J Psychiatry. 2013 May;58(5):260-73. doi: 10.1177/070674371305800503.
This review summarizes neurobiological and genetic findings in behavioural addictions, draws parallels with findings pertaining to substance use disorders, and offers suggestions for future research. Articles concerning brain function, neurotransmitter activity, and family history and (or) genetic findings for behavioural addictions involving gambling, Internet use, video game playing, shopping, kleptomania, and sexual activity were reviewed. Behavioural addictions involve dysfunction in several brain regions, particularly the frontal cortex and striatum. Findings from imaging studies incorporating cognitive tasks have arguably been more consistent than cue-induction studies. Early results suggest white and grey matter differences. Neurochemical findings suggest roles for dopaminergic and serotonergic systems, but results from clinical trials seem more equivocal. While limited, family history and genetic data support heritability for pathological gambling and that people with behavioural addictions are more likely to have a close family member with some form of psychopathology. Parallels exist between neurobiological and genetic and family history findings in substance and nonsubstance addictions, suggesting that compulsive engagement in these behaviours may constitute addictions. To date, findings are limited, particularly for shopping, kleptomania, and sexual behaviour. Genetic understandings are at an early stage. Future research directions are offered.
这篇综述总结了行为成瘾的神经生物学和遗传学发现,与物质使用障碍的相关发现进行了类比,并为未来的研究提供了建议。本文综述了涉及赌博、互联网使用、视频游戏、购物、偷窃癖和性行为等行为成瘾的脑功能、神经递质活动以及家族史和(或)遗传学发现的文章。行为成瘾涉及多个脑区的功能障碍,特别是额叶皮层和纹状体。结合认知任务的影像学研究结果比线索诱导研究更一致。早期结果表明存在白质和灰质差异。神经化学研究结果表明多巴胺和 5-羟色胺系统的作用,但临床试验的结果似乎更加不确定。虽然有限,但家族史和遗传数据支持病理性赌博的遗传性,以及行为成瘾者更有可能有近亲患有某种形式的精神病理学。物质和非物质成瘾的神经生物学、遗传学和家族史发现存在相似之处,这表明强迫参与这些行为可能构成成瘾。到目前为止,研究结果有限,特别是对于购物、偷窃癖和性行为。遗传理解处于早期阶段。本文提出了未来的研究方向。