National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, USA.
National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
Curr Top Behav Neurosci. 2022;58:147-165. doi: 10.1007/7854_2021_288.
Drug addiction has been defined as a chronically relapsing disorder that is characterized by a compulsion to seek and take a drug or stimulus, the loss of control in limiting intake, and the emergence of a negative emotional state when access to the drug or stimulus is prevented, a component of which is anhedonia. The present review explores a heuristic framework for understanding the role of anhedonia in addiction, in which anhedonia is a key component of hyperkatifeia (conceptualized as the potentiated intensity of negative emotional/motivational symptoms during drug withdrawal) and negative reinforcement in addiction. The neural substrates that mediate such anhedonia and crosstalk between elements of hyperkatifeia that contribute to anhedonia are then explored, including crosstalk between physical pain and emotional pain systems. The present review explores current knowledge of neurochemical neurocircuitry changes that are associated with conditioned hyperkatifeia/anhedonia. The overall hypothesis is that the shift in motivation toward negative reinforcement in addiction reflects the allostatic misregulation of hedonic tone, such that drug taking makes anhedonia worse during the process of seeking temporary relief by compulsive drug taking, thereby perpetuating the addiction cycle and hedonic comorbidities that are associated with addiction.
药物成瘾已被定义为一种慢性复发性疾病，其特征是强迫寻求和使用药物或刺激物，无法控制摄入，并且在阻止接触药物或刺激物时会出现负面情绪状态，其中一个组成部分是快感缺失。本综述探讨了一种理解快感缺失在成瘾中的作用的启发式框架，其中快感缺失是 hyperkatifeia（在药物戒断期间，将负面情绪/动机症状的强度增强）和成瘾中的负强化的关键组成部分。然后探讨了介导这种快感缺失的神经基质以及导致快感缺失的 hyperkatifeia 元素之间的串扰，包括身体疼痛和情绪疼痛系统之间的串扰。本综述探讨了与条件性 hyperkatifeia/快感缺失相关的神经化学神经回路变化的现有知识。总体假设是，成瘾中对负强化的动机转变反映了愉悦音调的适应不良调节，因此，在通过强迫性药物滥用寻求暂时缓解的过程中，药物使用会使快感缺失恶化，从而使成瘾循环和与成瘾相关的愉悦共病持续存在。
