Flashcards
week 1
Flashcards do conjunto (30)
- 1FLETCHER & KENNY 3 arguments against food addiction1. the evidence to speak of food addiction as similar to substance-addictions is lacking
2. the central features of substance addiction (tolerance, withdrawal) don't plausibly translate to food consumption
3. there's criticism on the studies that support the idea of food addiction - 2there are several studies showing that controlled manipulation of high-fat and/or high-sugar food availability provokes addiction-like patterns in rats. even reduced dopamine receptor function was found. what were 3 points of criticism on these studies?1. the results haven't been translated to humans yet
2. there's no convincing demonstrations that actual neurobiological changes indeed underly food addiction behaviours (early finding of reduced D2-receptor density in severely obese people was not replicated)
3. the addictive substance that is supposed to have a direct effect on the brain remains undiscovered for possible food addiction - 3those in favour of the idea of food addiction say that addiction should be viewed as a constellation of related syndromes that share similar, but not entirely overlapping, brain and behavior abnormalities of which a difficulty to control consumption is the most prominent. what are 3 arguments in favour of food addiction?1. SUDs are defined by feelings of deprivation when substance is withheld, relapse during abstinence, and compulsivity despite negative consequences. this is possible for food.
2. multiple fMRI studies show that energy-dense appetising food can stimulate changes in the activity of many of the same brain structures that are impacted by drugs of abuse (+ causal animal research: palatable food can impact mesolimbic dopamine system).
3. there's possibly not just one addictive substance in food, but it's rather the combination of multiple in a palatable high-calorie food that doesn't occur naturally - 4gambling disorder: what are the main requirements? + severity criteria, but without the list of symptoms- persistent and recurrent problematic gambling behaviour leading to significant impairment or distress, as indicated by the individual exhibiting 4 or more of the symptoms in a 12-month period
- the gambling behaviour is not better explained by a manic episode
- 4-5 is mild, 6-7 is moderate, 8-9 is severe - 5gambling disorder: 9 symptoms1. needing increased amounts of money to achieve desired excitement
2. repeated unsuccessful efforts to control, cut back, or stop gambling
3. has jeopardised or lost a significant relationship, job, or educational or career opportunity bc of gambling
4. is restless/irritable when attempting to cut down or stop
5. is often preoccupied with gambling
6. often gambles when feeling distressed
7. after losing money, often returning another day to get even
8. lies to conceal the extent of involvement with gambling
9. relies on others to provide money to relieve desperate financial situations caused by gambling - 6DSM criteria A-E of binge eating disorderA. Repeated episodes of binge eating.
B. The binge eating episodes are associated with 3 (or more) of the 5 characteristics
C. There is clear suffering from the binges.
D. occurs on average at least once a week for three months.
E. The binges are not accompanied by repeated inappropriate compensation behavior as in bulimia nervosa, and do not occur exclusively in the course of bulimia nervosa or anorexia nervosa. - 7what are the two characteristics of binge eating?1. Eating during a certain amount of time (for example, two hours) an amount of food that is significantly larger than most people would eat under the same conditions in such a period of time.
2. The feeling of having no control over food during the period - 8what are the five characteristics that binge eating can be associated with?- Eating much faster than usual.
- Continueing to eat until an unpleasant feeling arises of being full.
- Consuming large amounts of food without physical cravings.
- Eating secretly, out of shame of how much the person consumes
- Feeling disgusted afterwards, feeling gloomy or very guilty. - 9which disorders is gambling disorder often comorbid with? and what are two predictors of developing gambling disorder?substance abuse, and anxiety & mood-related disorders.
two predictors:
- living in a disadvantaged neighbourhood
- physical proximity to a casino - 10there are some purely physiological causes of obesity (e.g. metabolic disease), but (since the prevalence has almost doubled since 1980, to 30% of the word population being overweight/obese) the environment also plays an important role. what does 'obesogenic environment' mean?it's an environment that promotes or contributes to gaining weight. we are constantly confronted with tasty, high-calorie foods
- 11from an evolutionary perspective, how would you explain the obesity epidemic?for most of our history, there has been a lot of food scarcity periods in which people had to look for energy-rich foods in order to survive. this has created a brain network that regulates motivation and food-seeking (in which nucleus accumbens is prominent).
- 12CLARK: DISORDERED GAMBLING gambling disorder doesn't have any neurotoxic effects. how is this beneficial for research?by comparing those with gambling disorder to those with substance use disorder, it can be investigated whether vulnerability factors are the cause of addiction or the consequence of neurotoxic effects of addiction
- 13what is a shared vulnerability factor between those with gambling disorder and SUD? and which additional deficits did alcohol addicts show?impulsivity.
an alcohol-dependent group showed additional deficits in response inhibition and spatial working memory, which might thus reflect alcohol-induced changes in the lateral prefrontal cortex. - 14in which brain areas are (with an fMRI) consistent abnormalities found in those with a gambling disorder?- medial PFC
- amygdala
- insula
- striatum
however, some point to a hypoactive system (reward deficiency) while others point to a hyperactive system (sensitisation) - 15what did a PET scan study show about D2-receptor binding in those with gambling disorder vs. healthy individuals?no differences in D2-receptor binding.
however, higher density of D2 receptors was associated with less impulsivity (= vulnerability marker).
another PET study found an increased dopamine release in the dorsal striatum for patients with GD. - 16research on reward preference + resultsEvidence has found that rats getting a lever choice between cocaine and sucrose (sugar) reliably opted for the latter, even when chronically using cocaine. Thus, even when drugs are more potent, animals may nevertheless prefer natural rewards.
- 17computational model of addiction (Redish et al.), explanationa model that emphasizes that drug-induced stimulation of dopamine transmission is exogenous (external cause).
That is, for natural rewards there is no more firing to the US over the course of Pavlovian learning (because there is no prediction error): they only fire in response to the CS.
In contrast, the dopamine response does not diminish for drug rewards (the drug is the US): by stimulating the dopamine system, drugs of abuse continually elicit a US response next to a CS response, resulting in hyper-learning of drug-associated cues. - 18since behavioural addictions can only rely on natural or conditioned reinforcement mechanisms, how can behaviours become addictive? 2 approaches, without explanation1. adapted computational model for GD (Redish et al.)
2. cognitive distortions - 19what did research find on brain activity in response to the CS in those with GD?just like in the computational model of addiction, those with GD show greater brain activity when anticipating gambling rewards (in response to CS, like spinning of the wheels)
(but reduced activity to actual wins) - 20what's the adapted computational model for gambling disorder?on top of the original model (which emphasizes that drug-induced stimulation of dopamine transmission is exogenous), 2 features are added:
- big win hypothesis: many with GD describe receiving major payouts in the first few times that they ever gambled --> profound positive prediction errors that activate the neural systems of reinforcement learning.
- asymmetry in temporal-difference learning: financial gains (positive prediction error) promote learning acquisition, while financial losses (negative prediction errors) do not trigger unlearning, but rather promote hindsight bias. - 21what is hindsight bias in GD?explaining away of losses in a manner that does not ruin the player’s belief in
his/her ability to win. - 22the second explanation as to why people can become addicted to gambling, is that those with gambling disorder have cognitive distortions. explanation of gambling-related cognitive distortionssystematic errors in processing under conditions of chance. 2 common distortions are:
- illusion of control: the idea that one is developing some kind of skill over an outcome that is determined by chance alone, caused by irrelevant features of a game like making a choice (e.g. lottery number) or performing an action (e.g. throwing a die)
- gambler's fallacy: the belief that a certain random event is less or more likely to happen based on the outcome of previous events - 23which feature in a gambling game might fuel the illusion of control, and therefore fuel addiction?near misses: outcomes that are perceived as having been close to a win, but that are in fact objective losses.
Games that deliver moderate rates of near misses are played longer than machines that deliver none and near misses are perceived as more aversive than complete misses, but they do increase the desire to continue the game. - 24what are the effects of near misses on the brain?near misses have been shown to increase the neural signal in brain reward circuitry, compared to full misses. especially the anterior insula showed overlapping activity to wins and near misses.
- 25research design on the role of the insula in gambling + results4 groups:
- G1: lesions to the insula
- G2: lesions to the ventromedial PFC
- G3: lesions to the amygdala
- controls: no lesions
all performed 2 different gambling tasks.
results: G2, G3 and controls had enhanced motivation to play following near misses and gambler's fallacy.
G1: no enhanced motivation following near misses and no gambler's fallacy --> insula is causally involved in cognitive distortions in gambling addiction. - 26which bias do those with BED tend to have?a bias towards an option of immediate gratification with long-term negative consequences (body shape, physical health)
- 27WEBSITE CBT has been proven effective in treating GD. describe CBT for GDCBT teaches those with gambling problems to identify, question and change their thoughts and behaviours. It focuses on the relationship between a client’s thoughts, feelings and behaviours, and teaches them strategies and skills to identify and change problematic thoughts (cognitive distortions) and behavioural patterns. It gives an opportunity to confront core beliefs and adjust those.
- 28what are four elements/approaches of CBT for GD?1. raise awareness and correct cognitive distortions (e.g. gambler's fallacy or illusion of control)
2. substitute in healthier non-gambling behaviours
3. realising triggers
4. developing skills to prevent relapse - 29what's the evidence for CBT for GD?CBT reduces:
- the amount of money lost
- the severity of gambling.
Highly effective up to 24 months after completion of therapy.
No differences in the patient’s age, gender, ethnicity or psychiatric comorbidity.
Internet-based (self-directed) CBT and group settings are also effective. - 30what are the four CBT components for gambling disorder?1. psychoeducation: educating patients on the nature and characteristics of pathological gambling, incl raising awareness of cognitive distortions
2. functional analysis
3. stimulus-control measures (e.g. stimulus-control and stimulus-response prevention)
4. relapse-prevention (learn to identify high-risk situations and develop strategies to deal with those)
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- university ACD exam 2 FlashCards sobre week 1, criado por Sabine - em 09-05-2022.
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