Lebowitz Matthew S, Sorge Shawn T, Rattenni Rachel N
Department of Psychiatry, Columbia University, New York, NY 10032, USA.
Psychology Division, U.S Department of Veterans Affairs New York Harbor Healthcare System, New York, New York, 10010, USA.
Addict Res Theory. 2025;33(4):350-360. doi: 10.1080/16066359.2025.2468423. Epub 2025 Mar 3.
The role of the genome in the etiology of addictive disorders is increasingly emphasized, though the impact of this emphasis on people affected by addiction remains unclear. Furthering existing research on this topic, we sought to explore how attributing one's own addiction to genetic causes would relate to clinically relevant attitudes and beliefs, and whether any such impact would differ between people with substance addictions (alcohol use disorder in our sample) and those with behavioral addictions (gambling disorder in our sample).
Individuals affected by gambling disorder (GD; N=60) or alcohol use disorder (AUD; n=53) completed a measure of their belief in a possible genetic basis for their addictive disorder, as well as measures of beliefs about the effectiveness of medication and psychotherapy, characterological self-blame, and beliefs about their ability to overcome their addictive disorder. A subset of 20 participants completed qualitative follow-up interviews to explore their perspectives in greater depth.
In the GD sample, but not in the AUD sample, genetic attributions were positively associated with characterological self-blame; no other quantitative variables showed significant associations with genetic attributions. In the interviews, several participants expressed views of a genetic explanation for addiction as suggesting a need for biomedical (pharmacological) treatment. There was a diversity of views about whether a genetic explanation would indicate blamelessness on the part of the individual patient, as well as whether it would connote limited agency to overcome addiction through behavioral self-control.
Individuals with addictive disorders may endorse a variety of different perspectives about the implications of genetic explanations of addiction for treatment, self-efficacy, and blame, which may help to explain why quantitative associations between genetic attributions and other variables were not consistently observed.
尽管成瘾障碍病因中基因组的作用日益受到重视,但这种重视对成瘾者的影响仍不明确。为推进该主题的现有研究,我们试图探讨将自身成瘾归因于遗传原因与临床相关态度和信念之间的关系,以及这种影响在物质成瘾者(我们样本中的酒精使用障碍者)和行为成瘾者(我们样本中的赌博障碍者)之间是否存在差异。
受赌博障碍(GD;N = 60)或酒精使用障碍(AUD;n = 53)影响的个体完成了一项关于其对成瘾障碍可能的遗传基础的信念的测量,以及关于药物治疗和心理治疗效果的信念、性格自责和关于其克服成瘾障碍能力的信念的测量。20名参与者的子集完成了定性随访访谈,以更深入地探讨他们的观点。
在GD样本中,但不在AUD样本中,遗传归因与性格自责呈正相关;没有其他定量变量与遗传归因显示出显著关联。在访谈中,几位参与者表达了对成瘾的遗传解释的看法,认为这表明需要生物医学(药理学)治疗。对于遗传解释是否意味着个体患者无过错,以及它是否意味着通过行为自我控制克服成瘾的能力有限,存在多种观点。
成瘾障碍患者可能对成瘾的遗传解释对治疗、自我效能感和责备的影响支持多种不同观点,这可能有助于解释为什么没有始终观察到遗传归因与其他变量之间的定量关联。