Carroll Marilyn E, Smethells John R
Department of Psychiatry, University of Minnesota , Minneapolis, MN , USA.
Program in PharmacoNeuroImmunology, Department of Psychiatry, University of Minnesota , Minneapolis, MN , USA.
Front Psychiatry. 2016 Feb 8;6:175. doi: 10.3389/fpsyt.2015.00175. eCollection 2015.
The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, is discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug-abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as (1) using natural consequences such as non-drug rewards (e.g., exercise) to maintain abstinence, or using punishment as a consequence for drug use, (2) targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and (3) combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments.
本综述的目的是讨论与导致药物成瘾的行为失控中的性别差异相关的最新研究发现,并探讨其对人类的临床意义。本综述涵盖了在动物和人类中进行的研究,这些研究揭示了行为失控的基本方面。行为失控方面的性别差异,如冲动性和强迫性,作为药物成瘾的主要决定因素进行了讨论。青春期的行为失控也是一个重要的考虑因素,因为这是药物成瘾开始的时期。这些脆弱因素会累加增加药物滥用的易感性,并且它们是成瘾的组成部分,与性别差异共同变化并相互作用。还从治疗对改变成瘾行为背后的行为失控的能力方面,对药物成瘾治疗中的性别差异进行了综述。讨论了减少行为失控的定制治疗方法,例如:(1)利用自然结果,如非药物奖励(如运动)来维持戒断状态,或对药物使用进行惩罚;(2)通过重新利用药物来缓解潜在状况,针对行为失控的潜在因素,如冲动性或焦虑;(3)联合两种或更多种新的行为或药物治疗方法,以累加减少觅药行为。最近发表的研究表明,导致行为失控的因素是推进我们对药物滥用病因的认识、干预药物成瘾过程以及开发新治疗方法的重要靶点。