Fauth-Bühler M, Mann K
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
Addict Behav. 2017 Jan;64:349-356. doi: 10.1016/j.addbeh.2015.11.004. Epub 2015 Nov 24.
The number of massively multiplayer online games (MMOs) is on the rise worldwide along with the fascination that they inspire. Problems occur when the use of MMOs becomes excessive at the expense of other life domains. Although not yet formally included as disorder in common diagnostic systems, internet gaming disorder (IGD) is considered a "condition for further study" in section III of the DSM-5. The current review aims to provide an overview of cognitive and neurobiological data currently available on IGD, with a particular focus on impulsivity, compulsivity, and sensitivity to reward and punishment. Additionally, we also compare these findings on IGD with data from studies on pathological gambling (PG)-so far the only condition officially classified as a behavioral addiction in the DSM-5. Multiple similarities have been observed in the neurobiology of IGD and PG, as measured by alterations in brain function and behavior. Both patients with IGD and those with PG exhibited decreased loss sensitivity; enhanced reactivity to gaming and gambling cues, respectively; enhanced impulsive choice behavior; aberrant reward-based learning; and no changes in cognitive flexibility. In conclusion, the evidence base on the neurobiology of gaming and gambling disorders is beginning to illuminate the similarities between the two. However, as only a few studies have addressed the neurobiological basis of IGD, and some of these studies suffer from significant limitations, more research is required before IGD's inclusion as a second behavioral addiction in the next versions of the ICD and DSM can be justified.
全球范围内,大型多人在线游戏(MMO)的数量随着其激发的吸引力而不断增加。当MMO的使用过度并以牺牲其他生活领域为代价时,问题就会出现。尽管互联网游戏障碍(IGD)尚未正式被纳入常见诊断系统的疾病范畴,但在《精神疾病诊断与统计手册》第五版(DSM-5)的第三部分中被视为“有待进一步研究的状况”。本综述旨在概述目前关于IGD的认知和神经生物学数据,特别关注冲动性、强迫性以及对奖励和惩罚的敏感性。此外,我们还将IGD的这些研究结果与病理性赌博(PG)的研究数据进行比较——PG是目前DSM-5中唯一正式归类为行为成瘾的疾病。通过脑功能和行为的改变测量发现,IGD和PG在神经生物学方面存在诸多相似之处。IGD患者和PG患者均表现出损失敏感性降低;分别对游戏和赌博线索的反应性增强;冲动选择行为增强;基于奖励的学习异常;以及认知灵活性无变化。总之,关于游戏和赌博障碍神经生物学的证据基础开始揭示两者之间的相似性。然而,由于仅有少数研究探讨了IGD的神经生物学基础,且其中一些研究存在显著局限性,因此在IGD被纳入下一版《国际疾病分类》(ICD)和DSM并列为第二种行为成瘾之前,还需要更多的研究。