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Shared brain vulnerabilities open the way for nonsubstance addictions: Carving addiction at a new joint?
Author(s) -
Frascella Joseph,
Potenza Marc N.,
Brown Lucy L.,
Childress Anna Rose
Publication year - 2010
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2009.05420.x
Subject(s) - addiction , psychology , psychiatry , nicotine , behavioral addiction , clinical psychology
For more than half a century, since the beginning of formal diagnostics, our psychiatric nosology has compartmentalized the compulsive pursuit of substance (e.g., alcohol, cocaine, heroin, nicotine) from nonsubstance (e.g., gambling, food, sex) rewards. Emerging brain, behavioral, and genetic findings challenge this diagnostic boundary, pointing to shared vulnerabilities underlying the pathological pursuit of substance and nonsubstance rewards. Working groups for the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders , fifth edition (DSM‐V), are thus considering whether the nosologic boundaries of addiction should be redrawn to include nonsubstance disorders, such as gambling. This review discusses how neurobiological data from problem gambling, obesity, and “normal” states of attachment (romantic infatuation, sexual attraction, maternal bonds) may help us in the task of carving addictions “at a new joint.” Diagnostic recarving may have a positive effect on addiction research, stimulating discovery of “crossover” pharmacotherapies with benefit for both substance and nonsubstance addictions.