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行为成瘾中的线索反应性:一项荟萃分析及方法学考虑。

Cue-reactivity in behavioral addictions: A meta-analysis and methodological considerations.

机构信息

1 Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen , Duisburg, Germany.

2 Erwin L. Hahn Institute for Magnetic Resonance Imaging , Essen, Germany.

出版信息

J Behav Addict. 2018 Jun 1;7(2):227-238. doi: 10.1556/2006.7.2018.39. Epub 2018 May 23.

Abstract

Background and aims Recent research has applied cue-reactivity paradigms to behavioral addictions. The aim of the current meta-analysis is to systematically analyze the effects of learning-based cue-reactivity in behavioral addictions. Methods The current meta-analysis includes 18 studies (29 data sets, 510 participants) that have used a cue-reactivity paradigm in persons with gambling (eight studies), gaming (nine studies), or buying (one study) disorders. We compared subjective, peripheral physiological, electroencephal, and neural responses toward addiction-relevant cues in patients versus control participants and toward addiction-relevant cues versus control cues in patients. Results Persons with behavioral addictions showed higher cue-reactivity toward addiction-relevant cues compared with control participants: subjective cue-reactivity (d = 0.84, p = .01) and peripheral physiological and electroencephal measures of cue-reactivity (d = 0.61, p < .01). Increased neural activation was found in the caudate nucleus, inferior frontal gyrus, median cingulate cortex, subgenual cingulate, and precentral gyrus. Persons with gambling, gaming, or buying disorders also showed higher cue-reactivity toward addiction-relevant cues compared with control cues: subjective cue-reactivity (d = 0.39, p = .11) and peripheral physiological and electroencephal measures of cue-reactivity (d = 0.47, p = .05). Increased neural activation was found in the caudate nucleus, inferior frontal gyrus, angular gyrus, inferior network, and precuneus. Discussion and conclusions Cue-reactivity not only exists in substance-use disorders but also in gambling, gaming, and buying disorders. Future research should differentiate between cue-reactivity in addictive behaviors and cue-reactivity in functional excessive behaviors such as passions, hobbies, or professions.

摘要

背景与目的

近期研究已将线索反应范式应用于行为成瘾。本meta 分析的目的是系统分析行为成瘾中基于学习的线索反应的影响。

方法

本 meta 分析包括 18 项研究(29 个数据集,510 名参与者),这些研究在赌博障碍(8 项研究)、游戏障碍(9 项研究)或购买障碍(1 项研究)患者中使用了线索反应范式。我们比较了患者对成瘾相关线索和患者对成瘾相关线索与控制线索的主观、外周生理、脑电图和神经反应。

结果

与对照参与者相比,行为成瘾患者对成瘾相关线索的反应更高:主观线索反应(d=0.84,p=0.01)和外周生理及脑电图线索反应(d=0.61,p<0.01)。在尾状核、额下回、中央扣带回、扣带回下区和中央前回发现了更高的神经激活。赌博障碍、游戏障碍或购买障碍患者对成瘾相关线索的反应也高于对照线索:主观线索反应(d=0.39,p=0.11)和外周生理及脑电图线索反应(d=0.47,p=0.05)。在尾状核、额下回、角回、下网络和楔前叶发现了更高的神经激活。

讨论与结论

线索反应不仅存在于物质使用障碍中,也存在于赌博障碍、游戏障碍和购买障碍中。未来的研究应区分成瘾行为的线索反应和激情、爱好或职业等功能性过度行为的线索反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a509/6174580/06abf0c8af30/jba-07-02-39_f001.jpg

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