1. What is the aim of the article
2. What are important terms and explain them
3. What are the results of the article
4. What are the implications of the article
5. Are there any limitations? So yes, explain it
Sussman, S. (2017). Chapter 1: A general introduction to the concept of addiction and
addictive effects. In Substance and Behavioral Addictions: Concepts, Causes, and
Cures
Substance addiction pertains to repetitive intake of a drug or food, whereas behavioral addiction
pertains to engaging in types of behaviors repetitively which are not directly taken into the body such
as gambling or sex. Both result in clinically significant impairment. Until recently, science only
focused on addiction in the sense of misuse of drugs that lead to physiological withdrawal symptoms.
Researchers considered drugs which cross the blood-brain barrier, and exogenous ligands or
endogenous ligand functions (naturally occurring neurotransmitter). Behavioral addictions alter
endogenous ligand functions.
Obtaining a measurable description of a scientific concept such as addiction is useful to be able to
make inferences regarding how the concept is related to other concepts, and subsequently how the
concept can guide the development of useful application. The currently available definitions of
addiction are not mutually exclusive. Their boundaries are fuzzy. There are many recurrent, addictive
patterns of behavior that lead to clinically significant impairment. The concept of addiction may apply
broadly, but it is not trivial.
The historical records depict increasing engagement in certain behavior and reduction of alternative
behavior. The word addiction has evolved from referring to binding a person to something to being
more or less a brain disease. Addiction to tobacco has a brief public history. Alcohol misuse, on the
other hand, has been noted throughout written history. Furthermore, the initial use of opium was
described as divine enjoyment. Medication used to treat opium misuse often contained opium
themselves. Replacement medications that did not contain opiate led to new problematic cocaine use.
Marijuana also has a history of misuse. Contradictory, there is no ancient history regarding food
addiction. Historical literature presents descriptions of gambling and sex addictions. Behavioral
addictions have been studied empirically since the 1980s and are also referred to as process
addictions. Many behaviors that now refer to addictions were considered examples of vice, that is,
behaviors which are pleasurable, popular, possibly voluntary, and wicked.
There are two conceptions of addiction. An intensional definition of addiction pertains to causal or
process model type statements of addictions. They describe at minimum an addictive behavioral
process, and at maximum an etiology (causal story). An extensional definition of addiction provides
a taxonomy of addiction elements, which subsequently might be organized into a (more) intensional
theory-based perspective (more descriptive rather than etiologic). An alternative conceptualization
when considering elements/components of an addiction is that of family resemblances.
Physiological and psychological dependence (intensional)
,The physiological and psychological dependence definition of addiction states that an addiction is a
prolonged engagement in addictive behavior that results in its continued performance being necessary
for physiological and psychological equilibrium.
Tolerance, withdrawal, and craving are hallmark criteria of a dependence definition of addiction.
Tolerance refers to the need to engage in the behavior at a relatively greater level than in the past to
achieve previous levels of appetitive effects. As tolerance increases, one likely spends more time
locating and engaging in the addiction. Withdrawal is an abstinence syndrome, which involves
intense physical disturbance in the case of some types of drug abuse. They vary across drugs of abuse.
Behavioral addictions likewise exert withdrawal-like symptoms. Craving refers to an intense desire to
engage in a specific act. This intense desire reoccurs, is compelling, and one often gives in to this
desire. Craving might be considered part of the withdrawal syndrome in a dependence model of
addiction.
While many drug and non-drug addictions do not appear to produce obvious physical dependence,
they do create a subjective need for increased involvement in the behavior to achieve satiation.
Impulsive obsessive/compulsive behavior (intensional)
This definition of addiction pertains to engaging in the behavior due to a building up of tension which
is released, resulting in pleasure or relief. What occurs is another building up of tension or craving for
pleasure again (positive reinforcement). Alternatively, when the building up of tension doesn’t result
in pleasure but in relief of anxiety, it leads to obsessions which produce anxiety and stress leading to a
craving for relief again (compulsion, negative reinforcement). Withdrawal (negative factor) leads to
engagement in addictive behavior. It is plausible that both processes operate in the same person.
Compulsions involve spontaneous desires to act a particular way, a subjective sense of feeling
temporarily out of control, psychological conflict pertaining to the imprudent behavior, settling for
less to achieve the same ends, and a disregard for negative consequences. Arguably, obsessive-
compulsive disorder (OCD) and addictions may be overlapping constructs. However, many
researchers use the term compulsion more narrowly, defining it as a simple but intense urge to do
something (only one feature of addiction). OCD-related behaviors are defined as an intense ego-
dystonic urge to engage in a simple, repetitive activity, to remove anxiety. Conversely, an addiction
involves the attempt to achieve some desired appetitive effect and satiation through engagement in
some behavior (more complex behaviors).
Self-medication (intensional)
This definition pertains to relief from disordered emotions and sense of self-preservation through
engaging in addictive behavior (e.g., reaction to trauma). The emphasis is on where a person engages
in the behavior because the person feels sick and wants to feel well. Different behaviors (drugs) will
relieve different negative emotions (e.g., anger).
Self-regulation (intensional)
In a self-regulation model, the present state of being cues attempts to reach a standard at which point
satiation is achieved, until the present state is no longer at the desired standard state. In this sense,
people engage in addictive behavior in order to achieve an immediate temporary sense of comfort.
The BAS-BIS model, behavioral approach system and the behavioral inhibition, affects individual
differences in behavioral responses to cues for reward. These interdependent systems influence
whether an individual is likely to withdraw from or avoid situations that involve novel or threatening
,cues or whether a person is likely to engage in novel or risky behavior in response to cue for reward.
An active BAS (mediated by dopamine) is linked to more impulsive-type behaviors. An active BIS
(mediated by the septo-hippocampal system) is linked to inhibiting behavior. Persons with difficulty
in emotional self-regulation may be prone to engage in addictive behaviors in order to achieve an
immediate temporary sense of comfort. They are more likely to utilize the BAS which is not working
in sync with the BIS.
The incentive-sensitization theory focuses on the influence of neural adaption to addictive behaviors
and addictive behavior-conditioned stimuli as the underlying mechanism perpetuating the addictive
behaviors. This theory differentiates neural processes involved in motivational mechanisms or
incentive salience to addictive behavior cues (wanting) and the neural substrates of pleasurable
effects (liking). A progressive dysregulation of neural substrates occurs through repeated engagement
in the behavior, which, in turn, is associated with an increase in behavioral sensitization contributing
to addicts’ wanting the behavior becoming disproportionate to the pleasure derived from the behavior.
Through repeated engagement in the behavior, behavior-associated stimuli that acquire incentive
salience through neural representation (motivational wanting) become motivational magnets, able to
grab the addict’s attention. Adaptations in the wanting are affected by the pharmacological effects of
drugs, alterations in endogenous ligand transmissions, or associative learning.
Yet another explanation comes from the notion of allostasis. According to this notion, addictive
behavior leads to dopamine opponent-process counteradaptation (reduced dopamine and activation of
brain stress systems) that masks the effects of the addictive behavior. To increase dopamine
availability and initially control feelings of anxiety or stress, the addictive behavior may be repeated
again and again. New set points of homeostasis may then be established.
Addiction entrenchment (intensional)
In this model, one has an over-attachment to a drug, object, or activity (excessive appetite). Intrinsic
and extrinsic incentives addiction-promoting cognitive beliefs and expectancies drive the addictive
behavior forward. The qualities that make the behavior defined as addictive are in part the
conventionality of the behavior and one’s initial preferences, the excessiveness of involvement in the
behavior, and one’s place in society. With repeated participation in the behavior, the salience of
alternative behaviors decreases. Furthermore, it becomes more difficult to find the alternatives
(variance).
This notion is consistent with behavioral economics-type models of addiction-related behavior as
being a choice (a self-destructive operant behavior). Both show the existence of multiple schedules of
reinforcement associated with different behaviors (addictive vs. non-addictive), and they both involve
different reinforcement values and delays in delivery of reinforcement.
Six-component perspective (extensional)
This perspective has six different components. Salience refers to the tendency for the addiction to
dominate
one’s thoughts, feelings, and behavior. Mood modification refers to the rush, escape, or satisfaction
that the addictive behavior serves. Tolerance refers to the process in which more of the behavior is
required to achieve a level of mood modification. Withdrawal symptoms are the unpleasant feeling
states or physical effects of not engaging in the addictive behavior. Conflict refers to the discord
between engaging in the addictive behavior and relations with others, oneself, or engagement in other
, activities. Lastly, relapse refers to the tendency to return to out-of-control addictive behavior after
periods of trying to stop or control it.
Five-component perspective (extensional)
This perspective considers appetitive effects, satiation, preoccupation, loss of control, and negative
consequences as components. Tolerance and withdrawal symptoms are not included because this
perspective regards those components as preoccupation. As tolerance increases, one likely spends
more time locating and engaging in an addiction. If withdrawal symptoms exist, and worsen, one is
likely to be spending more and more time recovering from the after-effects of the addiction and be
focused in thought and action on how to cope. Both indicate increasing preoccupation.
DSM-5 (extensional)
The DSM-5 diagnoses a substance use disorder if the individual reports two or more of 11 criteria.
These criteria intend to reflect impaired control, social impairment, risky use, and pharmacologic
effects.
In the DSM-1, alcoholism and drug addiction were subsumed within a sociopathic personality
disturbance category (mental condition). In the DSM-2 a category of drug dependence was included
that was composed of physiologic (addiction) and psychic (state) components. Alcoholism was placed
in its own category (with four subdivisions). The DSM-3 distinguished between abuse and
dependence. It attempted to provide more empirical and within-person-based symptomatology by
considering multiple life dimensions. The DSM-4 defined drug abuse as a maladaptive pattern of drug
use leading to clinically significant impairment. They also had the diagnoses of substance
dependence, a more severe disorder. The DSM-5 established the current diagnostic criteria for
substance use disorder. The criteria are mostly a recombination of the DSM-4 criteria. First, the abuse
and dependence categories were combined into one substance use disorder diagnosis. Second, the
legal consequences criterion was removed. Finally, a craving criterion was added. The DSM-5 does
not recognize a food addiction category.
Gladwin, T. E., Figner, B., Crone, E. A., & Wiers, R. W. (2011). Addiction,
adolescence, and the integration of control and motivation.
Adolescence and addiction exemplify situations in which the development of motivational processes
can result in excessively risky or otherwise dysfunctional behavior. During adolescence, children
increasingly master the ability to control their behavior for the benefit of longer-term goals. However,
these advances in self-regulation abilities are accompanied by pronounced changes in motivational
processes.
Adolescents tend to take more and greater risks than individuals in other age groups in many life
domains. Typically, the occurrence of these risk-taking behaviors follows an inverted U-shape pattern
across development, peaking in adolescence. However, it should be noted that the inverted U-shape
observed in many everyday risk-taking behaviors remains somewhat elusive to assess with laboratory
risky choice tasks. Heightened involvement of affective processes in risky decision-making leads to
increased risk taking in adolescents, compared to children and adults (hot CCT). In contrast, when
risky decisions are made involving mainly deliberative processes and no or little affect, adolescents
show the same levels of risk taking as children and adults (cold CCT).
2. What are important terms and explain them
3. What are the results of the article
4. What are the implications of the article
5. Are there any limitations? So yes, explain it
Sussman, S. (2017). Chapter 1: A general introduction to the concept of addiction and
addictive effects. In Substance and Behavioral Addictions: Concepts, Causes, and
Cures
Substance addiction pertains to repetitive intake of a drug or food, whereas behavioral addiction
pertains to engaging in types of behaviors repetitively which are not directly taken into the body such
as gambling or sex. Both result in clinically significant impairment. Until recently, science only
focused on addiction in the sense of misuse of drugs that lead to physiological withdrawal symptoms.
Researchers considered drugs which cross the blood-brain barrier, and exogenous ligands or
endogenous ligand functions (naturally occurring neurotransmitter). Behavioral addictions alter
endogenous ligand functions.
Obtaining a measurable description of a scientific concept such as addiction is useful to be able to
make inferences regarding how the concept is related to other concepts, and subsequently how the
concept can guide the development of useful application. The currently available definitions of
addiction are not mutually exclusive. Their boundaries are fuzzy. There are many recurrent, addictive
patterns of behavior that lead to clinically significant impairment. The concept of addiction may apply
broadly, but it is not trivial.
The historical records depict increasing engagement in certain behavior and reduction of alternative
behavior. The word addiction has evolved from referring to binding a person to something to being
more or less a brain disease. Addiction to tobacco has a brief public history. Alcohol misuse, on the
other hand, has been noted throughout written history. Furthermore, the initial use of opium was
described as divine enjoyment. Medication used to treat opium misuse often contained opium
themselves. Replacement medications that did not contain opiate led to new problematic cocaine use.
Marijuana also has a history of misuse. Contradictory, there is no ancient history regarding food
addiction. Historical literature presents descriptions of gambling and sex addictions. Behavioral
addictions have been studied empirically since the 1980s and are also referred to as process
addictions. Many behaviors that now refer to addictions were considered examples of vice, that is,
behaviors which are pleasurable, popular, possibly voluntary, and wicked.
There are two conceptions of addiction. An intensional definition of addiction pertains to causal or
process model type statements of addictions. They describe at minimum an addictive behavioral
process, and at maximum an etiology (causal story). An extensional definition of addiction provides
a taxonomy of addiction elements, which subsequently might be organized into a (more) intensional
theory-based perspective (more descriptive rather than etiologic). An alternative conceptualization
when considering elements/components of an addiction is that of family resemblances.
Physiological and psychological dependence (intensional)
,The physiological and psychological dependence definition of addiction states that an addiction is a
prolonged engagement in addictive behavior that results in its continued performance being necessary
for physiological and psychological equilibrium.
Tolerance, withdrawal, and craving are hallmark criteria of a dependence definition of addiction.
Tolerance refers to the need to engage in the behavior at a relatively greater level than in the past to
achieve previous levels of appetitive effects. As tolerance increases, one likely spends more time
locating and engaging in the addiction. Withdrawal is an abstinence syndrome, which involves
intense physical disturbance in the case of some types of drug abuse. They vary across drugs of abuse.
Behavioral addictions likewise exert withdrawal-like symptoms. Craving refers to an intense desire to
engage in a specific act. This intense desire reoccurs, is compelling, and one often gives in to this
desire. Craving might be considered part of the withdrawal syndrome in a dependence model of
addiction.
While many drug and non-drug addictions do not appear to produce obvious physical dependence,
they do create a subjective need for increased involvement in the behavior to achieve satiation.
Impulsive obsessive/compulsive behavior (intensional)
This definition of addiction pertains to engaging in the behavior due to a building up of tension which
is released, resulting in pleasure or relief. What occurs is another building up of tension or craving for
pleasure again (positive reinforcement). Alternatively, when the building up of tension doesn’t result
in pleasure but in relief of anxiety, it leads to obsessions which produce anxiety and stress leading to a
craving for relief again (compulsion, negative reinforcement). Withdrawal (negative factor) leads to
engagement in addictive behavior. It is plausible that both processes operate in the same person.
Compulsions involve spontaneous desires to act a particular way, a subjective sense of feeling
temporarily out of control, psychological conflict pertaining to the imprudent behavior, settling for
less to achieve the same ends, and a disregard for negative consequences. Arguably, obsessive-
compulsive disorder (OCD) and addictions may be overlapping constructs. However, many
researchers use the term compulsion more narrowly, defining it as a simple but intense urge to do
something (only one feature of addiction). OCD-related behaviors are defined as an intense ego-
dystonic urge to engage in a simple, repetitive activity, to remove anxiety. Conversely, an addiction
involves the attempt to achieve some desired appetitive effect and satiation through engagement in
some behavior (more complex behaviors).
Self-medication (intensional)
This definition pertains to relief from disordered emotions and sense of self-preservation through
engaging in addictive behavior (e.g., reaction to trauma). The emphasis is on where a person engages
in the behavior because the person feels sick and wants to feel well. Different behaviors (drugs) will
relieve different negative emotions (e.g., anger).
Self-regulation (intensional)
In a self-regulation model, the present state of being cues attempts to reach a standard at which point
satiation is achieved, until the present state is no longer at the desired standard state. In this sense,
people engage in addictive behavior in order to achieve an immediate temporary sense of comfort.
The BAS-BIS model, behavioral approach system and the behavioral inhibition, affects individual
differences in behavioral responses to cues for reward. These interdependent systems influence
whether an individual is likely to withdraw from or avoid situations that involve novel or threatening
,cues or whether a person is likely to engage in novel or risky behavior in response to cue for reward.
An active BAS (mediated by dopamine) is linked to more impulsive-type behaviors. An active BIS
(mediated by the septo-hippocampal system) is linked to inhibiting behavior. Persons with difficulty
in emotional self-regulation may be prone to engage in addictive behaviors in order to achieve an
immediate temporary sense of comfort. They are more likely to utilize the BAS which is not working
in sync with the BIS.
The incentive-sensitization theory focuses on the influence of neural adaption to addictive behaviors
and addictive behavior-conditioned stimuli as the underlying mechanism perpetuating the addictive
behaviors. This theory differentiates neural processes involved in motivational mechanisms or
incentive salience to addictive behavior cues (wanting) and the neural substrates of pleasurable
effects (liking). A progressive dysregulation of neural substrates occurs through repeated engagement
in the behavior, which, in turn, is associated with an increase in behavioral sensitization contributing
to addicts’ wanting the behavior becoming disproportionate to the pleasure derived from the behavior.
Through repeated engagement in the behavior, behavior-associated stimuli that acquire incentive
salience through neural representation (motivational wanting) become motivational magnets, able to
grab the addict’s attention. Adaptations in the wanting are affected by the pharmacological effects of
drugs, alterations in endogenous ligand transmissions, or associative learning.
Yet another explanation comes from the notion of allostasis. According to this notion, addictive
behavior leads to dopamine opponent-process counteradaptation (reduced dopamine and activation of
brain stress systems) that masks the effects of the addictive behavior. To increase dopamine
availability and initially control feelings of anxiety or stress, the addictive behavior may be repeated
again and again. New set points of homeostasis may then be established.
Addiction entrenchment (intensional)
In this model, one has an over-attachment to a drug, object, or activity (excessive appetite). Intrinsic
and extrinsic incentives addiction-promoting cognitive beliefs and expectancies drive the addictive
behavior forward. The qualities that make the behavior defined as addictive are in part the
conventionality of the behavior and one’s initial preferences, the excessiveness of involvement in the
behavior, and one’s place in society. With repeated participation in the behavior, the salience of
alternative behaviors decreases. Furthermore, it becomes more difficult to find the alternatives
(variance).
This notion is consistent with behavioral economics-type models of addiction-related behavior as
being a choice (a self-destructive operant behavior). Both show the existence of multiple schedules of
reinforcement associated with different behaviors (addictive vs. non-addictive), and they both involve
different reinforcement values and delays in delivery of reinforcement.
Six-component perspective (extensional)
This perspective has six different components. Salience refers to the tendency for the addiction to
dominate
one’s thoughts, feelings, and behavior. Mood modification refers to the rush, escape, or satisfaction
that the addictive behavior serves. Tolerance refers to the process in which more of the behavior is
required to achieve a level of mood modification. Withdrawal symptoms are the unpleasant feeling
states or physical effects of not engaging in the addictive behavior. Conflict refers to the discord
between engaging in the addictive behavior and relations with others, oneself, or engagement in other
, activities. Lastly, relapse refers to the tendency to return to out-of-control addictive behavior after
periods of trying to stop or control it.
Five-component perspective (extensional)
This perspective considers appetitive effects, satiation, preoccupation, loss of control, and negative
consequences as components. Tolerance and withdrawal symptoms are not included because this
perspective regards those components as preoccupation. As tolerance increases, one likely spends
more time locating and engaging in an addiction. If withdrawal symptoms exist, and worsen, one is
likely to be spending more and more time recovering from the after-effects of the addiction and be
focused in thought and action on how to cope. Both indicate increasing preoccupation.
DSM-5 (extensional)
The DSM-5 diagnoses a substance use disorder if the individual reports two or more of 11 criteria.
These criteria intend to reflect impaired control, social impairment, risky use, and pharmacologic
effects.
In the DSM-1, alcoholism and drug addiction were subsumed within a sociopathic personality
disturbance category (mental condition). In the DSM-2 a category of drug dependence was included
that was composed of physiologic (addiction) and psychic (state) components. Alcoholism was placed
in its own category (with four subdivisions). The DSM-3 distinguished between abuse and
dependence. It attempted to provide more empirical and within-person-based symptomatology by
considering multiple life dimensions. The DSM-4 defined drug abuse as a maladaptive pattern of drug
use leading to clinically significant impairment. They also had the diagnoses of substance
dependence, a more severe disorder. The DSM-5 established the current diagnostic criteria for
substance use disorder. The criteria are mostly a recombination of the DSM-4 criteria. First, the abuse
and dependence categories were combined into one substance use disorder diagnosis. Second, the
legal consequences criterion was removed. Finally, a craving criterion was added. The DSM-5 does
not recognize a food addiction category.
Gladwin, T. E., Figner, B., Crone, E. A., & Wiers, R. W. (2011). Addiction,
adolescence, and the integration of control and motivation.
Adolescence and addiction exemplify situations in which the development of motivational processes
can result in excessively risky or otherwise dysfunctional behavior. During adolescence, children
increasingly master the ability to control their behavior for the benefit of longer-term goals. However,
these advances in self-regulation abilities are accompanied by pronounced changes in motivational
processes.
Adolescents tend to take more and greater risks than individuals in other age groups in many life
domains. Typically, the occurrence of these risk-taking behaviors follows an inverted U-shape pattern
across development, peaking in adolescence. However, it should be noted that the inverted U-shape
observed in many everyday risk-taking behaviors remains somewhat elusive to assess with laboratory
risky choice tasks. Heightened involvement of affective processes in risky decision-making leads to
increased risk taking in adolescents, compared to children and adults (hot CCT). In contrast, when
risky decisions are made involving mainly deliberative processes and no or little affect, adolescents
show the same levels of risk taking as children and adults (cold CCT).
