Addiction and Compulsive Disorders Block 2 Overview summary by Bente Niemeijer
Content overview
Transdiagnostic perspective 3
Advantages of RDoC 4
DSM-Criteria Substance Use Disorder (SUD) 5
DSM-Criteria gambling disorder (GD) 5
Interaction between dopamine system and drug use 5
Dopamine system and learning 6
Epidemiology and treatment of gambling disorder 6
What defines addiction? 7
What makes gambling addictive? 8
Clinical picture of obesity and the food-addiction debate 10
Three dopamine pathways 12
The compulsive brain 13
DSM-Criteria Anorexia Nervosa (AN) 14
DSM-Criteria Bulimia Nervosa (BN) 14
DSM-Criteria Binge Eating Disorder (BED) 14
DSM-Criteria Avoidant Restrictive Food Intake Disorder (ARFID) 15
Epidemiology of feeding and eating disorders 15
Comorbidities of feeding and eating disorders 16
Clinical picture of eating disorders 16
Animal models and genetic markers of eating disorders 18
Treatment of eating disorders 18
Obsessive thoughts in mental disorders 21
DSM-Criteria OCD 21
Epidemiology of OCD 21
Comorbidities of OCD and differential diagnosis 21
Clinical picture of OCD 22
A phenomenology of OCD 24
Theoretical models of OCD 26
Treatment of OCD 26
Modules that explain the effect of exposure therapy 30
,Addiction and Compulsive Disorders Block 2 Overview summary by Bente Niemeijer
Goal directed actions versus habitual actions 30
Measuring real-life habits 32
Habits and mental disorders 32
Substance use disorder and habits 32
Eating disorders and habits 34
OCD and habits 35
Implementation intentions 38
How do implementation intentions overrule habits? 40
Executive (i.e. cognitive control) functions in mental disorders 41
Aetiology of restrictive-type eating disorders 43
Aetiology of bulimic spectrum eating disorders 43
, Addiction and Compulsive Disorders Block 2 Overview summary by Bente Niemeijer
Transdiagnostic perspective
• Compulsivity (broad definition): behavior that is continued despite explicit knowledge of profound
negative consequences.
• Endophenotype: biological or psychological phenomena of a disorder believed to be in the causal chain
between genetic contributions to a disorder and diagnosable symptoms of psychopathology
• Transdiagnostic perspective: common underlying processes are believed to play a role in the
development and maintenance of various disorders. Benefits of this approach:
• Transdiagnostic processes can serve as therapeutic targets
• It gains insight into the psychological and neurobiological basis of compulsive behavior
• A transdiagnostic approach can support translation of effective clinical interventions.
• Transdiagnostic processes:
1. Learning processes
• Pavlovian conditioning: a change in behavior due to experience with a relationship between a
(neutral) conditioned stimulus (CS) and a (motivationally relevant) unconditioned stimulus (US)
• Operant/instrumental conditioning: a change in behavior caused by a relationship between an
instrumental response (R) and a motivationally relevant outcome (O)
2. Cognitive control processes (i.e. ‘top-down’ executive functions)
3. Neurobiological processes
• RDoC1 (Research Domain Criteria): a research framework for investigating mental disorders, that
integrates many levels of information to explore dimensions of functioning of humans, from normal to
abnormal behaviour.
• Its goal is to foster new research approaches that will lead to better diagnosis, prevention, intervention,
and cures. RDoC is not meant to serve as a diagnostic guide or to replace current diagnostic systems.
• Instead of utilising symptoms and signs for disease state definitions and then seeking specific
pathologies, RDoC reverses the perspective by considering psychopathology in terms of deviations
from normal functions in six domains that could account for particular symptoms:
1. Arousal/regulatory
2. Positive valence
3. Negative valence
4. Sensorimotor
5. Cognitive
6. Social processes
• Different aspects of each domain are represented by psychological and biological dimensions (units of
analysis: behavior, genetics, physiology, and self-report data).
• Equally important is the study of various aspects of the environment, including the physical
environment, cultural components, and social determinants of health.
• Both behavioral and biological aspects of functioning change and mature across the life span, and so
research on development is thought of as essential.
• Positive Valence Systems2:
1. Reward Anticipation: ability to anticipate future positive reinforcer
1 For the information on RDoC and the advantages of this framework, the following source was used: What is RDoC? (n.d.). National
Institute Of Mental Health (NIMH). https://www.nimh.nih.gov/research/research-funded-by-nimh/rdoc/about-rdoc
2 This is according to the information on Canvas, which differs from how the valance systems are organized on the RDoC website
Content overview
Transdiagnostic perspective 3
Advantages of RDoC 4
DSM-Criteria Substance Use Disorder (SUD) 5
DSM-Criteria gambling disorder (GD) 5
Interaction between dopamine system and drug use 5
Dopamine system and learning 6
Epidemiology and treatment of gambling disorder 6
What defines addiction? 7
What makes gambling addictive? 8
Clinical picture of obesity and the food-addiction debate 10
Three dopamine pathways 12
The compulsive brain 13
DSM-Criteria Anorexia Nervosa (AN) 14
DSM-Criteria Bulimia Nervosa (BN) 14
DSM-Criteria Binge Eating Disorder (BED) 14
DSM-Criteria Avoidant Restrictive Food Intake Disorder (ARFID) 15
Epidemiology of feeding and eating disorders 15
Comorbidities of feeding and eating disorders 16
Clinical picture of eating disorders 16
Animal models and genetic markers of eating disorders 18
Treatment of eating disorders 18
Obsessive thoughts in mental disorders 21
DSM-Criteria OCD 21
Epidemiology of OCD 21
Comorbidities of OCD and differential diagnosis 21
Clinical picture of OCD 22
A phenomenology of OCD 24
Theoretical models of OCD 26
Treatment of OCD 26
Modules that explain the effect of exposure therapy 30
,Addiction and Compulsive Disorders Block 2 Overview summary by Bente Niemeijer
Goal directed actions versus habitual actions 30
Measuring real-life habits 32
Habits and mental disorders 32
Substance use disorder and habits 32
Eating disorders and habits 34
OCD and habits 35
Implementation intentions 38
How do implementation intentions overrule habits? 40
Executive (i.e. cognitive control) functions in mental disorders 41
Aetiology of restrictive-type eating disorders 43
Aetiology of bulimic spectrum eating disorders 43
, Addiction and Compulsive Disorders Block 2 Overview summary by Bente Niemeijer
Transdiagnostic perspective
• Compulsivity (broad definition): behavior that is continued despite explicit knowledge of profound
negative consequences.
• Endophenotype: biological or psychological phenomena of a disorder believed to be in the causal chain
between genetic contributions to a disorder and diagnosable symptoms of psychopathology
• Transdiagnostic perspective: common underlying processes are believed to play a role in the
development and maintenance of various disorders. Benefits of this approach:
• Transdiagnostic processes can serve as therapeutic targets
• It gains insight into the psychological and neurobiological basis of compulsive behavior
• A transdiagnostic approach can support translation of effective clinical interventions.
• Transdiagnostic processes:
1. Learning processes
• Pavlovian conditioning: a change in behavior due to experience with a relationship between a
(neutral) conditioned stimulus (CS) and a (motivationally relevant) unconditioned stimulus (US)
• Operant/instrumental conditioning: a change in behavior caused by a relationship between an
instrumental response (R) and a motivationally relevant outcome (O)
2. Cognitive control processes (i.e. ‘top-down’ executive functions)
3. Neurobiological processes
• RDoC1 (Research Domain Criteria): a research framework for investigating mental disorders, that
integrates many levels of information to explore dimensions of functioning of humans, from normal to
abnormal behaviour.
• Its goal is to foster new research approaches that will lead to better diagnosis, prevention, intervention,
and cures. RDoC is not meant to serve as a diagnostic guide or to replace current diagnostic systems.
• Instead of utilising symptoms and signs for disease state definitions and then seeking specific
pathologies, RDoC reverses the perspective by considering psychopathology in terms of deviations
from normal functions in six domains that could account for particular symptoms:
1. Arousal/regulatory
2. Positive valence
3. Negative valence
4. Sensorimotor
5. Cognitive
6. Social processes
• Different aspects of each domain are represented by psychological and biological dimensions (units of
analysis: behavior, genetics, physiology, and self-report data).
• Equally important is the study of various aspects of the environment, including the physical
environment, cultural components, and social determinants of health.
• Both behavioral and biological aspects of functioning change and mature across the life span, and so
research on development is thought of as essential.
• Positive Valence Systems2:
1. Reward Anticipation: ability to anticipate future positive reinforcer
1 For the information on RDoC and the advantages of this framework, the following source was used: What is RDoC? (n.d.). National
Institute Of Mental Health (NIMH). https://www.nimh.nih.gov/research/research-funded-by-nimh/rdoc/about-rdoc
2 This is according to the information on Canvas, which differs from how the valance systems are organized on the RDoC website
