O le Neurobiology o Vaisu ma Amio (2006)

COMMENTS: One of many peer-reviewed studies that state the obvious: behavioral and drug addictions extensively overlap in neural pathways, brain mechanisms, and behaviors.
FROM THIS REVIEW: ” Multiple lines of evidence support a relationship between behavioral and substance addictions. For example, behavioral and substance addictions share common core clinical features: repetitive or compulsive engagement in a behavior despite adverse consequences; diminished control over the problematic behavior; an appetitive urge or craving state prior to engagement in the problematic behavior; and a hedonic quality during the performance of the problematic behavior.3 In addition, evidence suggests that impulse-control disorders often share other common features with substance use disorders, including aspects of tolerance, withdrawal, repeated unsuccessful attempts to cut back or stop, and impairment in major areas of life functioning “

Full Study: The Neurobiology of Substance and Behavioral Addictions

lē faʻatino

tua

E tele amio, e ese mai i le malosi o le gaosiga o mea taumafa, maua ai se taimi puupuu e mafai ona faatupuina ai amioga faifai pea e ui lava i le malamalama i taunuuga leaga, o lona uiga, faaitiitia le pulea o le amioga. O nei faaletonu ua leva ona faamatalaina i le tele o auala. O le tasi manatu e mafua ai nei faaletonu ao taoto i se fusi o le manava-malosi, faatasi ai ma nisi ua faavasegaina o le le pulea o le malosi. O se isi mea, ae le o se mea e tasi, manatu faʻale-manatu e faʻafitauli o mea e le o se vailaʻau poʻo ni mea faʻaleagaina.

sini

Faʻamatala le talanoaga i luga o le sootaga i le va o le mafaufau ma le tagofia o mea ua fai ma vaisu. Metotia: Matou te iloiloina faʻamatalaga e faʻaalia ai mea e talitutusa ma eseesega i le faʻafitauli o le pulea o le manaʻoga poʻo le tagofia o mea ua fai ma vaisu ma vaisu. O lenei autu e sili ona talafeagai i le tuʻufaʻatasiga aupito sili ona lelei o nei faʻafitauli i le lomiga lona lima o le American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders.

i'uga

O le faʻamalosia o molimau e faʻaalia ai le tagofia o mea ua fai ma vaisu e pei o le tagofia o vailaau oona i le tele o vaega, e aofia ai le tala faasolopito o le lalolagi, le manava o le tino, faapalepale, faʻamalosi, gaosia o gaioiga, neurobiological mechanisms, ma tali i togafitiga, lagolago le DSM-V Task Force e aofia uma ai mea e faʻaaoga ai vailaʻau ma vailaau e leai ni vailaʻau. O faʻamatalaga o loʻo i ai nei o loʻo fautuaina ai e mafai e lenei vaega tuʻufaʻatasiga ona talafeagai mo taaloga faʻaletonu ma nai isi mea e sili atu ona suʻesuʻeina i mea tau vaisu, faʻataʻitaʻiga, vaisu i Initaneti. O loʻo i ai nei le le lava o faʻamatalaga e faʻamaonia ai soʻo se faʻavasegaga o isi mea ua fai ma vaisu ua fuafuaina.

Faaiuga ma le Taua Faasaienisi

O le faʻavasega lelei o vaisu amio poʻo faʻafitauli o le faʻalavelave faʻalavelave ua i ai le tele o aʻafiaga mo le atiaʻeina o le faʻaleleia atili o togafitiga ma togafitiga togafitiga.

uputatala: amioga faʻafeusuaiga, faʻavasegaga, siamaina, faʻafitauli le pulea o le manaʻo, faʻafitauli o le vailaʻau, faʻamalosi, faʻaaogaina o fualaau faasaina, manaʻoga

faʻatomuaga

E tele amio, e ese mai i le malosi o le gaosiga o mea taumafa, maua ai se taimi puupuu e mafai ona faatupuina ai amioga faifai pea e ui lava i le malamalama i taunuuga leaga, o lona uiga, faaitiitia le pulea o le amioga. O le faʻaitiitia o le puleaina o se autu o faʻamalamalamaina le manatu o le mafaufau i le mafaufau ma le faʻalagolago i ai. O lenei tutusa na mafua mai ai le manatu o mea e le o se vailaau po o "vaisu", o lona uiga, o ni faaletonu e tutusa ma vaisu o vailaau, ae o se vaaiga tau amioga nai lo le gaosia o se mea oona. O le manatu o vaisu amioga e iai nisi suʻesuʻega faasaienisi ma aoga, ae tumau pea le feeseeseaiga. O mataupu e uiga i vaisu o amioga ua faʻatalanoaina i le taimi nei i le atinaʻe o le DSM-V (1,2)

O nisi o vaisu amioga ua manatu e tutusa lelei ma vaisu o vailaʻau. Le Taiala Faʻapitoa ma le Fuainumera Faʻamaumauga, 4^th O le lomiga (DSM-IV-TR) ua uma ona filifilia ni tulaga masani o suʻesuʻega mo nisi o nei faaletonu (e pei o le taʻavale faʻaletonu, kleptomania), faʻavasegaina i latou o ni faʻafitauli o le manaʻoga, se isi vaega mai le faʻaaogaina o vailaʻau. O isi amioga (poʻo le faʻafitauli o le faʻaosoosoina) na mafaufauina mo le aofia ai i le DSM o loʻo oʻo mai - faʻatau malosi, pathologic pega o le paʻu, vaisu o feusuaiga (faʻafeusuaiga faʻasalalau), soona tanning, komipiuta / ata vitio, ma le initaneti. O a amioga e aofia ai le tagofia o mea ua fai ma vaisu e tatala pea mo fefinauaiga (3). E le o faʻafitauli uma o le manaʻoga, poʻo le faʻalavelave e mafua mai i le le mautonu, e tatau ona mafaufau i vaisu amioga. E ui lava o le tele o le faʻafitauli o le manava (faʻataʻitaʻiga, taʻavale faʻamalosi, kleptomania) e foliga mai e faʻamatalaina vaega autu o vailaau oona, o isi, e pei o le faʻalavelave faʻafuaseʻi o le afaina, atonu e leai. I le faʻamoemoe o le saofagā i lenei felafolafoaiga, o lenei pepa o loʻo iloiloina ai le faʻamaoniga mo mea tutusa i le va o vaisu amioga ma le faʻaaogaina o vailaau faʻasoesa, o latou tulaga ese mai maʻi le mautonu, ma faailoa ai vaega o le le mautonu e manaʻomia ai suʻesuʻega i le lumanaʻi. E avea foi o se folasaga i pepa o loʻo mulimuli mai i lenei lomiga, lea e toe iloiloina nisi o amioga faʻatusa o le tagofia o vaisu.

Auala Taatele o Faʻaleagaga Faʻafeusuaiga: Fegalegaleaiga ma Mea Faʻaaoga Faʻafitauli

O le vaega taua o mea ua fai ma vaisu amioga o le le mafai lea ona tetee atu i se tuinanau, taʻavale, poʻo se faaosoosoga e faia se mea e leaga ai le tagata poʻo isi foi (4). Soʻo se amio faʻafeusuaiga e faʻaalia i se faʻaauau pea o amioga e iai lenei uiga taua i totonu o se vaega patino. O le toe fai soo i nei amioga e matua aʻafia ai le galue i isi vaega. I lenei itu, o vaisu amio e tutusa ma le le atoatoa o le faʻaaogaina o mea. O tagata taʻitoʻatasi o loʻo i ai vailaau o vailaau faʻasolosolo e faigata i le teenaina o le manaʻo e inuina pe faʻaaoga fualaau.

O vailaau faʻaleagaina ma vailaʻau faʻatele e tele lava mea e talitutusa i le tala faʻanatura, mea faʻapitoa, ma aʻafiaga leaga. Ua amata uma i latou i le talavou ma le talavou matutua ma maualuga atu i nei vaitausaga nai lo matua matutua (5). E tofu uma lava ma tala faanatura e mafai ona faʻaalia ai masani masani, toe faʻaleleia mamanu, ae o le toʻatele o tagata e toe faʻafoe na oi latou lava e aunoa ma se togafitiga (faʻaaogaina "leai se taimi")6).

O vaisu e le masani ai e masani ona muamua i lagona o le "le mautonu po o le fagua ao le i faia le gaoioiga" ma le "fiafia, faamalieina po o le toomaga i le taimi o le faia o le gaoioiga" (4). O le natura-syntonic natura o nei amioga e masani lava ona tutusa ma le poto masani o amioga faʻaaoga. E feteenai lenei mea ma le natura-dystonic natura o le atuatuvale ma le le mautonu. Ae peitai, o amioga uma ma vailaau oona e mafai ona itiiti ifo le tupe-telefoni ma sili atu tupe-dnystonic i luga o le taimi, aua o le amio (e aofia ai le mea e fai) e le maua ai le fiafia ma sili atu o se masani poo se faʻamalosi (2,7), poʻo le faʻamalosia e itiiti e ala i le faʻamalosia lelei ma sili atu e ala i le faʻamalosia le lelei (faʻataʻitaʻiga, toomaga o le dysphoria poʻo le tolopoina).

O vailaʻau faʻaleagaina ma vailaʻau faʻapitoa e tutusa lelei. O le toʻatele o tagata e fai ma vaisu amioga e lipoti atu se manaʻoga poʻo se manaʻoga i le tino ao le i amataina le amio, e pei ona faia e tagata taʻitoʻatasi e faʻaaogaina le vailaau oona ae leʻi faʻaaogaina mea. E le gata i lea, o nei amio e masani ona faʻaitiitia ai le popole ma mafua ai i se tulaga lelei o le amio poʻo le "maualuga", e tutusa ma le soona inu. O le dysregulation faalelagona e mafai ona saofagā i le manaʻoga i faʻafitauli uma o amioga ma le faʻaaogaina o mea (8). O le toʻatele o tagata e iai le lafoaʻia o taaloga tau tupe, kleptomania, amio feusuaʻiga mataga, ma le faʻatau faʻatau faʻataʻitaʻiga o se faʻaitiitia o nei uiga lelei lelei i amio masani poʻo se manaʻoga e faʻalauteleina le malosi o le amio ina ia ausia le tutusa o lagona o lagona, tutusa ma le faapalepale (9-11). O le toʻatele o tagata e iai nei vaisu amioga e lipotia ai foʻi se tulaga o le dysphoric aʻo latou aloese mai amioga, e tutusa ma le tuai. Ae ui i lea, e le pei o mea e aveeseina, e leai ni lipoti o le tulaga o le physiologia poʻo le faʻasolosolo o le mafaufau ma le mafaufau e taʻu mai i vaisu amioga.

O le le fiafia i taaloga, o le sili ona suʻesuʻeina lelei o mea ua fai ma vaisu, ua tuʻuina atu ai nisi faʻamatalaga i le vaʻaia o vaisu o amioga ma le faʻaaogaina o vailaau (vaai foi Wareham ma Potenza, lenei lomiga). O taaloga faʻaletupe e le masani ona amata i le laʻititi poʻo le talavou, faatasi ai ma tama e amata ona amata i le matua (5,12), faʻataʻitaʻi le mamanu o le faʻaaogaina o vailaʻau. O le maualuga o le tele o taaloga faʻavaomalo o loo matauina i alii, ma o le telescoping o mea na matauina i tamaitai (ie, o tamaitai ua i ai se taimi mulimuli ane o le auai i amioga o mea ua fai ma vaisu, ae ua umi le taimi mai le taimi na amata ai ona fai ma vaisu) (13). O le telescoping phenomenon ua uma ona tusia i ni vailaau eseese o le faʻaaogaina o vailaau (14).

E pei o le faʻaaogaina o mea faʻafitauli, o faʻafitauli tau tupe ma le faʻafitauli e masani ona masani i vaisu amioga. O tagata taʻitoʻatasi e fai ma vaisu amioga, e pei oi latou e iai vailaau oona, o le a masani ona faia ni amioga faasolitulafono, e pei o le gaoi, faʻatauvalea, ma le tusiaina o siaki leaga, i le faʻatupeina oa latou amioga fai ma vaisu poʻo le taulimaina o taunuuga o le amio (15).

uiga

O tagata taʻitoʻatasi e faʻaaogaina mea ua fai ma vaisu ma i latou o loʻo faʻaaogaina vailaʻau o loʻo faʻaogaina le maualuga i luga o le lipoti a le tagata lava ia o le le mautonu ma le sailia o lagona ma e masani lava ona maualalo i luga o auala e faʻaleagaina ai (16-20). Ae ui i lea, o tagata taʻitoʻatasi e iai ni mea ua fai ma vaisu, e pei ole vaisu i luga o le initaneti poʻo le le fiafia i mea tau tupe, e mafai foi ona lipotia mai tulaga maualuga o le aloese mai le faʻaleagaina (21; faʻaaliga foi Weinstein ma Lejoyeux, lenei lomiga). O isi suʻesuʻega ua fautua mai o vaega o le mafaufau faʻaletonu, feteʻenaʻiga, ma le faʻatinoina o le tagata lava ia atonu e tofu uma lava ma vaega o le initaneti (vaai Weinstein ma Lejoyeux, lenei lomiga). I le eseesega, o tagata taʻitoʻatasi o loʻo i ai le faʻalavelave faʻamalosi e masani lava ona sikoa maualuga i luga o auala o le faʻaleagaina o le aloese ma le maualalo i luga o le le mautonu (17,21). O tagata taʻitoʻatasi e fai ma vaisu amioga e tutusa lelei le fua o le faʻamalosi, ae atonu e faʻamapulaʻaina i le le lelei o le pulea o gaoioiga a le mafaufau ma popolega e uiga i le le toe pulea o amioga afi (22). O le le lelei o le faʻamaloina o tali faʻafuasei (impulsivity) ua maua i tagata taʻitoʻatasi o loʻo i ai le faʻalavelave faʻaleagaina ma le pathologically skin picking (o se vaisu o amioga ma e le taumateina e sili atu ona vavalalata sootaga i mea e le mautonu), ae o le mafaufauga o le mafaufau (mafaufau e saofagā i le faʻamalosia) vaivai faamalosi (23,24).

Comorbidity

E ui lava o le tele o suʻesuʻega a le atunuʻu e leʻi aofia ai le suʻesuʻega o vaisu amioga, o faʻamatalaga faʻamaʻi o loʻo iai i le taimi nei o le fesoʻotaʻiga i le va o le faʻalauiloaina o mea tau tupe ma le faʻaaogaina o vailaʻau, faatasi ai ma le maualuga o le felagolagomaʻi i itu taʻitasi (25,26). O le suʻesuʻega a le St. Louis Epidemiologic Catchment Area (ECA) na maua ai le maualuga o fua faʻatasi mo le faʻaaogaina o vailaʻau (e aofia ai le faʻalagolago i le nicotine) ma gaioiga faʻaletonu, faatasi ai ma le maualuga o le maualuga o le masaniga masani i le va o taaloga petipeti, faʻafitauli o le ava,25). O se suʻesuʻega faʻamaʻi a Kanata na fuaina ai le aʻafiaga o aʻafiaga mo le faʻaaogaina o le ava malosi na faʻateleina le 3.8-pe a oʻo mai le taʻaloga faʻasalalau (27). Faatasi ai ma tagata taʻitoʻatasi ma mea e faalagolago i ai, o le lamatiaga o le maualuga i le televave o taaloga eseese tau tupe na 2.9 taimi maualuga (28). O aʻafiaga faʻavave mai le 3.3 i le 23.1 ua lipotia i le va o faʻataʻitaʻiga faʻaletonu ma le faʻaaogaina o le ava malosi i suʻesuʻega faʻavae a le US (25; 29). O le tagofia o le Initaneti na fesoʻotai ma le faʻaaogaina o le ava malosi (tulaga tutusa o le 1.84) i se suʻesuʻega a tamaiti aʻoga o 2,453, ina ua uma ona puleaina le itupa, tausaga ma le atuatuvale (30).

O faʻataʻitaʻiga faʻaleleia o isi mea ua fai ma vaisu o amioga ua fautuaina ai o le faʻatasi ai ma le faʻaaogaina o vailaʻau e taatele (Laulau 1). O nei suʻesuʻega ua fautua mai ai o vaisu amio e mafai ona faʻasoa se faʻasologa masani o le faʻaaogaina o vailaau faʻasoesa.

O le Fuafuaga Faʻavaitausaga o le Faʻaaogaina o Faʻafitauli Faʻafitauli i Faʻafitauli Faʻaleagaina

Peitaʻi, o faʻamatalaga e uiga i le vailaʻau e faʻaaogaina ai le faʻaleagaina e tatau ona faʻamatalaina ma le faʻaeteete ona o soʻo se faʻalapotopotoga faʻapitoa e mafai ona faʻaalia i luga o se amio (faʻataʻitaʻiga, faʻaaogaina e le ava malosi le tele o amioga le talafeagai, e aofia ai i latou na faʻamaonia) afaina amioga e amata i le maea o togafitiga o le ava, atonu o se mea suitulaga mo le inu). O tagata taʻavale faʻalavelave e masani ona faʻaaogaina le ava malosi e sili atu le tele o taaloga tau tupe ma sili atu faʻafitauli tau mafaufauga e mafua mai i taaloga nai lo tagata e leai se ava e faʻaaogaina talafaasolopito (31), ma o tamaiti matutua o loʻo faʻavaitaimi i le tele o meainu inu e sili atu ona televavave le taʻalo nai lo i latou e le o faia (32), ma fautua mai ai se fegalegaleaiga amio i le va o le ava malosi ma le taaloga faitupe. I le eseesega, o se sailiiliga tutusa e faatatau i le faaaogaina o le nicotine e faʻaalia ai se fegalegaleaiga faʻasalaga, e pei o le mea moni e faʻapea, o tagata matutua o loʻo i ai le vavalalata faʻaletupe o loʻo i ai nei po o tagata ulaula na muamua atu,33). O tagata taʻavale faʻafitauli e faʻaaogaina tapaa i aso taʻitasi o le a sili atu ona i ai le faʻaaogaina o ava malosi ma fualaau faasaina (34).

O isi faaletonu o le mafaufau, e pei o le tele o le atuatuvale o le tino, le maʻi maʻi pipili, maʻi le mautonu, ma le le atoatoa o le le atoatoa o le tino, e masani ona lipotia i le fesootaʻi ma vaisu o amioga (35,36, tagai foi Weinstein ma Lejoyeux, lenei lomiga). Ae ui i lea, o le tele o nei suʻesuʻega faʻatapulaʻa na faʻavae i faʻataʻitaʻiga faʻapitoa. O le tele o nei faʻamaumauga e faʻateleina i faʻataʻitaʻiga a le nuʻu e tumau pea ona fuafuaina.

Neurocognition

O vailaau faʻaleagaina ma faʻaaogaina o vailaʻau e mafai ona i ai uiga masani masani. O tagata taʻavale faʻamalosi ma tagata taʻitoʻatasi o loʻo faʻaaogaina vailaʻau faʻasolosolo e masani lava o le faʻasalaga taui vave (37) ma faia le le lelei i luga o galuega fai filifiliga (38) e pei o le Iowa Gambling Task, o se faʻataʻitaʻiga e iloilo ai le faia o le faʻamoemoega o le faia o filifiliga (39). I le eseesega, o se suʻesuʻega o tagata taʻitoʻatasi i luga o le initaneti ua faʻaalia ai le leai o ni faʻaletonu i le faia o faʻaiuga i luga o le galuega o tafaoga a Iowa (40). O se suʻesuʻega e faʻaaogaina ai se masini e le o le malosi i le 49 o tagata taʻavale, o 48 o loʻo faʻaaogaina le ava malosi, ma o pulega 49 na maua e tagata taaalo ma ava malosi le faʻaitiitia o faʻatinoga i luga o suʻesuʻega o le faʻafeiloaʻiga, fetuutuunai o le mafaufau, ma le fuafuaina o galuega, ae leai ni eseesega i suʻega a galuega faʻatinoina (41).

Faʻasologa masani o Neurobiological

Ole tino tuputupu aʻe o tusitusiga e aʻafia ai le tele o le neurotransmitters system (eg, serotonergic, dopaminergic, noradrenergic, opioidergic) i le pathophiosiology o vaisu amioga ma le faʻaaogaina o vailaʻau (disorders)42). Aemaise lava, o le serotonin (5-HT), lea e aofia ai ma le puipuia o amioga, ma le dopamine, e aofia ai le aoaoina, faaosofiaga, ma le ola maloloina o fualaau faasaina, e aofia ai taui, e mafai ona fesoasoani tele i vaega uma o le faaletonu (42,43).

O faʻamaoniga mo le faʻaogaina o serotoner i amioga faʻafeusuaiga ma le faʻaaogaina o vailaʻau e sau i se vaega mai suʻesuʻega o le pata o le monoamine oxidase B (MAO-B), lea e fetaui ma maualuga o le 5-hydroxyindole acetic acid (5-HIAA, metabolite o le 5-HT) ma ua avea o se faʻasologa faʻasolo o le galuega 5-HT. Low CSF 5-HIAA maualuga e faʻamaopoopo ma maualuga maualuga o le le mautonu ma le sailia o lagona ma ua maua i le le fiafia i taaloga tau tupe ma le faʻaaogaina o mea (44). O suʻesuʻega faʻapitoa tau fomai tipitipi suʻesuʻeina o le fuaina o le tali faʻataʻitaʻi pe a maeʻa le faʻaaogaina o vailaʻau faʻataʻitaʻiina e maua ai faʻamaoniga mo le faʻaleagaina o le serotonerical i mea uma ua fai ma vaisu ma amioga faʻaletonu (45).

O le faʻaaoga faifai pea o vailaʻau poʻo le faʻamalosi i se vaisu o amioga pe a maeʻa se faʻamalosia e mafai ona atagia ai se faʻagasologa tasi. O suʻesuʻega faʻasolosolo ma suʻesuʻega o suʻesuʻega o loʻo fautua mai ai o se faʻalauiloaina o meaola mo mea faʻalavelave faʻamalosia e mafai ona aafia ai le gaioiga o le ulufale atu i le tau o le faʻaaogaina o le faʻalapotopotoga /46,47). O le faʻalauteleina o le lautele e aofia ai ni neu e faʻasaʻo le dopamine i le nucleus accumbens ma le vevela o le pito i luma. O suiga i auala dopaminergic ua uma ona fuafuaina e avea ma autu o le sailia o taui (taaloga faitupe, fualaau) lea e mafua ai le faamatuu atu o le dopamine ma maua ai lagona o le fiafia (48).

O faʻamaoniga faʻamaonia mai suʻesuʻega e faʻaogaina ai suʻesuʻega e lagolagoina ai le neurocircuitry interactions o vaisu amioga ma le faʻaaogaina o vailaau faʻaleagaina (7). O le faʻaitiitia o le gaioiga o le vialite i luma o le vialia (vmPFC) na fesoʻotaʻi ma le faia o filifiliga faʻamalosi i iloiloga o taui ma le faʻaitiitia o tali i faʻamatalaga tau tupe i totonu o tagata taʻavale faʻaleagaina (49). E pei foi o galuega masani a le vmPFC ua maua i tagata e faaletonu le faʻaaogaina o mea (50). O faʻataʻitaʻiga e faia i le faia o faiʻai i luga o le initaneti e faʻaalia i totonu o le isi lava oʻai faiʻai (poʻo le faʻailoga, muagagana muamua, tuaina o le ogatotonu, nucleus accumbens) e pei o le faʻamalosia o le faia o le faiʻai i fualaau faʻasaina (51; see also Weinstein and Lejoyeux, lenei lomiga ).

O suʻesuʻega faʻataʻitaʻiga o ata e taʻu mai ai o le dopaminergic mesolimbic ala mai le faʻalauteleina o le faʻaleleia o le faʻalautele i le nucleus accumbens e mafai ona aʻafia i le faʻaaogaina o vailaʻau faʻasolosolo ma le le fiafia i taaloga. O mataupu e faʻatautaia taaloga faʻavaitaimi na faʻaalia ai le tele o galuega faʻava-o-malo ma le fMRI ao faia le faʻataʻitaʻituina o tupe siliva nai lo le pulea o tagata (52), e talitutusa ma faʻataʻitaʻiga i mataupu e faʻatatau i le ava malosi pe a fai le totogi o tupe (53). O le faʻaitiitia o le faʻamalosia o le faʻalauiloaina o le tino na aʻafia ai foi i manaʻoga e fesoʻotai ma vailaau ma amioga faʻafeusuaiga (41). O le auai i se galuega tau taʻaloga e foliga mai e faʻaalia ai le tuʻuina atu o le dopamine sili atu i le televise i tagata taitoatasi e maua ai le maʻi o Parkinson (PD) ma le le fiafia i mea tau tupe nai lo tagata taitoatasi ma PD toatasi (54), o se tali tali tutusa ma lea na mafua mai fualaau faasaina po o fualaau faasaina i vailaʻau faasaina (55).

O le aafia o le Dopamine i vaisu amioga e fautuaina foi e suesuega o tagata mamaʻi PD ua togafitia (56,57). E lua suʻesuʻega o tagata gasegase ma le PD na latou iloa e sili atu nai lo le 6% le faʻataʻitaʻiina o se faʻafitauli fou o le tagofia o mea ua fai ma vaisu po o le le atoatoa o le faʻalogo (faʻapitoa, taaloga faʻaletonu, faʻafeusuaiga i feusuaiga), ma le maualuga tele atu i latou o loʻo faia le vailaʻau o le dopamine (agonist medication)58,59). O le maualuga o levo-dopa o le fuafaatatau o meaʻai na fesoʻotai ma le sili atu ona ono mafai ona i ai se vaisu amio (59). E feteenaʻi ma le mea e mafai ona faʻamoemoeina mai le aʻafia o le dopamine, o faʻataʻitaʻiga i le dopamine D2 / D3 faʻaleleia faʻaleleia faʻamalosiaga ma amio i tagata e le o ni PD tagata e le fiafia i taaloga (tupe faʻapitoa)60) ma e leai se aoga i le togafitiga o le vavalalata faʻaletupe (61,62). O isi suʻesuʻega e tatau ona faamanino ai le sao o le dopamine i le faʻalauiloaina o taaloga tau tupe ma isi mea ua fai ma vaisu.

Talafaasolopito o Aiga ma Genetics

E itiiti lava ni suʻesuʻega o talafaasolo- pito o aiga / genetics e uiga i vaisu amioga ua uma ona fuafuaina ma vaega talafeagai e pulea (7). Suesuega laiti a aiga e uiga i faʻasologa faʻasolosolo faʻatasi ai ma le faʻalauiloaina o taaloga faitupe (63), kleptomania (64), poʻo le faʻatau faʻatau (65) na maua ei latou uma o le aiga muamua o le faʻasolosolo mea e sili atu ona maualuga le maualuga o le ola o le ava malosi ma isi mea e faʻaaogaina ai vailaʻau, ma le atuatuvale ma isi faʻafitauli o le mafaufau, nai lo le pulea o mataupu. O nei suʻesuʻega a le aiga e lagolagoina ai le manatu e ono iai se vaʻaiga o le gasegase o mea e fai ma vaisu.

O le gasegase e fesoʻotaʻi ma le faʻaogaina o le siosiomaga i amioga ma faʻafitauli e mafai ona faʻatusalia e ala i le faʻatusatusaina o la latou felagolagomaʻi i paʻu tutusa (monozygotic) ma fragalua (dizygotic) twins. I le suʻesuʻeina o masaga tamaʻitaʻi e faʻaaoga le Vietnam Era Twin Registry, 12% i le 20% o le fesuiaiga o le fesuiaiga o lamatiaga ma 3% i le 8% o le fesuiaiga o le siʻosiʻomaga o le siʻosiʻomaga i le lamatiaga mo gaioiga faʻaletonu na mafua mai i le lamatiaga o le ava faʻaaoga faʻafitauli (66). O le lua-vae tolu (64%) o le mea na tupu i le va o le faʻaletonu o mea tau tupe ma le faʻaaogaina o le ava e mafua mai i gaioiga e aʻafia uma ai maʻi e lua, e faʻatonuina ai le sologa lelei i lalo o vaevaega e lua. O nei sailiiliga e talitutusa ma na o loʻo fautuaina mai ai faʻasinomaga masani i le tele o faʻafitauli o le faʻaaogaina o vailaʻau (67).

E tele lava suʻesuʻega faʻasolosolo o fualaau faʻamaʻi e uiga i vaisu amioga. O le eletise D2A1 o le generator receptor D2 dopamine (DRD2) e faʻateleina ai le tele o taimi mai tagata taʻitoʻatasi e leai ni faafitauli i vaʻaiga tau tupe i le faʻalavelave faʻaletupe ma faʻatasi ai ma le faʻaletonu o mea tau taaloga ma le faʻaaogaina o mea (68). O le tele o le DRD2 gene single nucleotide polymorphisms (SNPs) e fesoʻotaʻi ma uiga faʻalegata o le vaivai ma le faʻataʻitaʻiga o le faʻasaina o amioga i tagata soifua fuamalie soifua maloloina (69), ae o nei mea e le i iloiloina i tagata ei ai vaisu amioga. O le tele o le initaneti i luga o le upega tafailagi o loʻo maua ai le maualuga o le uumi (SS) o le serotonin transporter gene (5HTTLPR) nai lo le soifua mālōlōina, ma o lenei mea na aʻafia ai ma le aloese mai le faʻaleagaina (70;

Tali atu i togafitiga

O vailaʻau faʻaleagaina ma vailaʻau faʻaaoga e masani lava ona tali lelei i togafitiga e tasi, e le gata i le mafaufau ma le falemaʻi. O le 12-step step self-help approaches, faʻaleleia o le faʻamalosi, ma togafitiga faʻamalosi masani e faʻaaogaina e togafitia ai le faʻaaogaina o vailaau faʻasolosolo ua faʻaaoga lelei e togafitia ai taaloga faʻapitoa, faʻamalosia o amioga feusuai, kleptomania, pathologic pepese peʻa, ma faʻatau faʻatau (71-74). O faʻafitauli faʻapitoa mo le faʻaaogaina o mea ua fai ma vaisu ma le faʻaaogaina o vailaʻau e tele lava ina faalagolago i se faʻasologa o le puipuia o le toe faʻafoʻiina o mea e faʻamalosia ai le faʻasaʻo e ala i le faailoaina o mamanu faʻaleagaina, aloese poʻo le faʻafetaui ma tulaga lamatia, ma le suia o olaga e faamalosia ai amioga sili atu. I le eseesega, o togafitiga manuia a le mafaufau mo le le mautonu-faamalosi faamalosi e faamamafa mai ai le faalauiloaina ma le puipuiga o tali (2).

E leai ni vailaʻau ua faʻatagaina nei mo le togafitiga o vaisu o amioga, ae o nisi vailaʻau na faʻaalia i le togafitiga o le faʻaaogaina o vailaʻau faʻaalia ua faʻaalia foi le folafolaina i le togafitia o vaisu o amioga (75). O le Naltrexone, o se tagata faʻatautau o le talipidate o le faʻataʻitaʻiina e le US Food and Drug Administration mo le togafitiga o le ava malosi ma le faalagolago i le opioid, ua faaalia ai le aoga tele i suega faʻapitoa mo togafitiga o gaioiga faʻaletonu ma le kleptomania (76-79), ma folafola atu i suʻesuʻega le pulea e uiga i le faʻatau faʻatau (80), amioga faʻamalosi faʻafeusuaiga (81), vaisu i le initaneti (82), ma le pathologically picking skin (83). O nei suʻesuʻega ua fautua mai ai o le au faʻataʻitaʻi o le inu-o-opioid e tutusa lava le latou matafaioi i vaisu o amioga e pei ona latou faia i le faʻaaogaina o vailaʻau, atonu e ala i le faʻaogaina o le auala mimolimbic dopaminergic. I le eseesega, o le tagata faʻataunuʻu o le inu o le receptor o le naloxone e faʻataunuʻuina ai faʻamaoniga i le atuatuvale ma le faʻalavelave faʻaleagaina (84).

O fualaau e suia ai le faʻaaogaina o le glutamatergic ua faʻaaogaina foi e togafitia ai mea ua fai ma vaisu amio ma mea faʻalagolago i mea. O Topiramate, o se tagata faʻasalaga lea na poloka le sub-tape AMPA o le glutamate receptor (faatasi ai ma isi gaioiga), ua faʻaalia ai le folafolaga i luga o faʻasalalauga faʻasalalau o gaioiga faʻaletonu, faʻatau malosi, ma le faʻamalosiina o peʻa (85), faʻapea foʻi ma le aoga i le faʻaitiitia o le ava malosi (86), sikaleti (87), ma cocaine (88) faaaoga. N-acetyl cysteine, o le amino acid lea e toe faʻaleleia ai le maualuga o le glutamate i le nucleus accumbens, faʻaitiitia ai faʻamalosiaga ma amioga i se suʻesuʻega se tasi o tagata taʻavale faʻaletonu (89), ma faʻaitiitia ai le manaʻoina o le koko (90) ma le faʻaaogaina o le koko (91) i meaʻai o le koko. O nei suʻesuʻega o loʻo fautua mai ai o le faʻaaogaina o le dopaminergic leo i totonu o le tumutumu o le tumutumu atonu o se masini e taatele i vaisu amioga ma faʻafitauli o le vailaʻau (92).

Faʻamatalaga Faʻamatalaga

E naʻo le tasi vaisu amio, gaioiga faʻaletonu, o se faʻamatalaga iloga i le DSM-IV ma le ICD-10. O ona tulaga suʻesuʻega e tutusa lelei lava ma le faʻaaogaina o vailaau / faʻalagolago i le vailaʻau, o lona uiga, o le popole i le amio, faʻaitiitia le malosi e pulea ai amioga, faapalepale, tosoina, ma aʻafiaga o le mafaufau. O le DSM-V Task Force ua fautuaina le faia o taaloga faʻapitoa mai le vavalalata o loʻo i ai i le taimi nei o se faʻafitauli o le manava o le manaʻoga i se faʻavasegaga fou ua taua o "Addiction and Disorders Related," o le a aofia ai le faʻaaogaina o vailaʻau faʻasolosolo ma "mea e leai ni vailaʻau" (www.dsm5.org, faʻafeiloaʻi ia Fepuari 10, 2010). Naʻo le pau le suiga ua suia i le tulaga o suʻesuʻega o le faʻaitiitia o le faitioga e uiga i le faia o gaoioiga faasolitulafono e faʻatupeina ai tupe faʻaletupe, lea na maua ai e itiiti le faʻaogaina ma le itiiti o aʻafiaga i le siama.

Ole tele o isi mea ua fai ma vaisu ua faʻatulagaina ai faʻataʻitaʻiga, e aofia ai faʻatau faʻatau (93), Vaisu i Initaneti (94), vailaau vitio / komipiuta i mea tau taaloga (95), vaisu o feusuaiga (96), ma le tanning tele (silasila Kouroush et al., lenei lomiga). E masani lava ona faʻavae i luga ole DSM-IV tulafono mo le faʻaaogaina o vailaʻau poʻo le faʻalagolago, e pei o le tele o le taimi na faʻaaluina i le amio, toe taumafai pea e le manuia e tipi pe taofi le amio, faʻaitiitia le puleaina o amio, faapalepale, tosoina, ma faʻaleagaina le mafaufau taunuuga. O le DSM-V Vailaau e fesoʻotaʻi atu i mea e aʻafia ai le mafaufau o loʻo mafaufau i le tele o nei vailaʻau e leai ni vailaʻau mo le aofia ai i le DSM-V, faʻapitoa ona taʻua le tagofia o le Initaneti (www.dsm5.org; faʻafeiloaʻi ia Fepuari 10, 2010). Ae ui i lea, mo le tele o faaletonu, e itiiti pe leai foi faʻamaumauga mo nei tulaga faʻamaonia; oi latou nei o loʻo sili ona aoga i le taimi nei o meafaigaluega e suʻe ai suʻesuʻega e fuafua ai le faʻaogaina o le faafitauli.

O se tasi o fesili faʻafanoʻi na tulaʻi mai i le tusiga, o fea e fai ai vaisu faʻamaʻi (ma vailaʻau vailaau) i luga o le le malosi o le malosi o le tino (compulsivity)97), o lona uiga, pe sili atu ea i latou e pei o le faʻalavelave faʻavaivai poʻo le faʻanoanoa o le faʻalavelave faʻalavelave? O nisi ua finau e faapea, o lenei tulaga le tasi o le auala e sili atu ona faigofie, ma o le le mautonu ma le faamalosia e faatusaina i itu, ae le o itu faafeagai o se vaega e tasi (98). E ogatusa ma le finauga mulimuli o ni sailiiliga e pei o le tele o suiga i le tikeri o le le mautonu o tagata ei ai amioga ua fai ma vaisu, suiga e mafai ona fesootai ma tali i togafitiga faafomaʻi (48, 99).

I le DSM-IV, o vailaau vailaʻau (faʻaaogaina o vailaʻau) o se vaega tutoʻatasi, aʻo gaioiga faʻaleagaga ua manatu o se maʻi le pulea, e pei o le, pyromania ma kleptomania. O le ICD-10 o loʻo faʻavasegaina taaloga faʻapitoa e pei o se "amioga ma le manaʻoga," ae iloa ai "o le amio e le malosi i le tomai faʻapitoa," e ui lava o nisi taimi e taʻua o le "televave taaloga."

O se mataupu e fesoʻotai i ai o le mafutaga, poʻo le fusi, pe a fai ei ai, i vaʻaiga eseese o vaisu. O se auiliiliga o fuainumera o fuainumera o tagata lautele ma falemaʻi i totonu o le 210 tagata mamaʻi ma le maʻi faʻamaʻaloga autu na faʻamaonia ai ni tuʻuga eseese se lua o tagata gasegase e fai ma vaisu amioga (100): o gasegase e maua ai le faʻalauiloaina o tupe faitupe poʻo feusuaiga faʻafeusuaiga ("feusuaʻiga") e leʻi leva ona amataina ma e sili atu ona foliga mai o le tane, pe a faatusatusa atu i tagata o loʻo i ai le gaioiga malosi. E manaʻomia isi suʻesuʻega e faʻamaonia ma faʻalauteleina lenei sailiga. O se tasi o suʻesuʻega e ono tele sona saofaga i le fanua o le a avea ma iloiloga atoatoa o se vaega tele, eseese, lelei o le faʻalapotopotoga o tagata taitoatasi e eseese a latou amioga ma vailaau oona i tulaga o vaega taua o le le mautonu ma le faʻamalosia i le mafaufau (mafaufau) ma le amio ( taavale), faʻataʻitaʻiga, faʻalogo i le tolopoina o le totogi (faʻaitiitia o le totogi o le tino), faʻataunuʻuina o le faʻamasinoga, faʻatautaia le mafaufau, tali vave, tali atu, taliina tali, ma le faʻaaogaina o aʻoaʻoga.

Aotelega ma Faaiuga

O faʻataʻitaʻiga tuputupu aʻe o loʻo faʻamaonia ai o vaisu amioga e pei o vailaau o vailaau i le tele o vaega, e aofia ai le tala faanatura (masani, toe faʻaleleia o le auala ma le maualuga ma le faʻaauau i tupulaga talavou ma talavou matutua), o mea faʻapitoa (manaʻoga tuinanau, inisua ["maualuga"], , faʻaupuga, faʻaaogaina o foaʻi faʻapitoa, neurobiological mechanisms (with roles for brain glutamatergic, opioidergic, serotonergic and dopamine mesolimbic systems), ma tali i togafitiga. Ae ui i lea, o faʻamatalaga o loʻo i ai e sili ona tele mo taaloga faʻaletupe (silasila i Wareham ma Potenza, lenei lomiga), faʻatasi ai ma faʻamaumauga maʻoti mo le faʻatau faʻatau (tagai Lejoyeaux ma Weinstein, lenei lomiga), vaisu i le initaneti (silasila Weinstein ma Lejoyeaux, lenei lomiga), ma (vii Weinstein, lenei lomiga), ma e toetoe lava leai se faʻamatalaga mo isi vaisu amioga e pei o le tagofia o feusuaiga (tagai i le Garcia ma Thibaut, lenei lomiga), alofa i mea ua fai ma vaisu (tagai i le Reynaud, lenei lomiga), pathologically skin picking (see Odlaug ma Grant, lenei lomiga), poo le tanning tele (see Kouroush et al., Lenei lomiga). E lava le faʻamaoniga i le faʻamaonia e mafaufau ai i taaloga faʻaletonu e le o se vailaau poʻo se mea ua fai ma vaisu amio; o le DSM-V Task Force ua fautuaina le siitia o lona faʻavasegaina i le DSM-V mai se faʻafitauli o le manava o le tino i se vaisu ma faʻalavelave faʻalavelave (o se vaega fou e aofia uma ai vailaʻau ma vailaau e leai ni vailaʻau) .. I le tulaga o loʻo iai nei, aemaise lava i le leai o ni faʻamaumauga faʻamaonia faʻamaonia ma suʻesuʻega umi, suʻesuʻega umi, e le o toe vave mafaufau i isi mea ua fai ma vaisu e pei o ni faʻafitauli tutoʻatasi, e itiiti lava le faʻavasegaina uma e tutusa ma vailaau oona, ae le o le faʻafitauli o le faʻaosooso. Suesuega ole lumanai, e aofia ai suʻesuʻega a tagata ma manu (101), e manaʻomia e aumai ai lo tatou iloa e uiga i vaisu amioga i le maualuga o lena mea mo vailaau o vailaʻau, aemaise lava i vaega o genetics, neurobiology (e aofia ai ma mafaufau mafaufau), ma togafitiga.

tautinoga

Lagolagoina e le Polokalame Suʻega Suesuega, National Institutes of Health, National Institute on Drug Abused; NIH (NIDA) faʻatagaina le R01 DA019139 (MNP) ma le RC1 DA028279 (JEG); ma le Minnesota ma le Yale Centers of Excellence i le Faʻatalosaga Taaloga, lea o loʻo lagolagoina e le National Center for Gamble Gaming ma lana Inisitituti mo Suʻega i Taaloga Fefaʻatauaʻiga. Dr. Weinstein e lagolagoina e le National Institute of Institute for Psychobiology. O mea o loʻo i le manusuga ua na o le matafaioi a tusitala ma e le o se sui aloaia o le Nofoaga Autu a le Atunuu mo Taʻaloga Tauvaga poʻo le Inisitituti mo Suʻega i Taaloga Fefaʻatauaʻiga poʻo soʻo se isi lava lala o loʻo faʻatupeina.

Faamatalaga Faʻamatalaga

Faʻamaumauga a le tusitala: O tusitala uma na lipotia mai e leai se feteʻenaʻiga e uiga i mea o loʻo i totonu o lenei pepa. Ua maua e Dr. Grant ni fesoasoani tau sailiiliga mai le NIMH, NIDA, Nofoaga Tutotonu a le National Fun Fun Gaming ma lana Initaneti o Suesuega mo Taaloga Taaloga, ma Vaomatua Vaomatua. Ua maua e Dr. Grant le taui faaletausaga mai Springer Publishing mo le avea ma faatonu-o-le-ofisa o le Journal of Gaming Studies, ua ia faia ni iloiloga faameaalofa mo le NIH ma le Ontario Cambling Association, na mauaina ni totogi mai le Oxford University Press, American Psychiatric Publishing, Inc. , Norton Press, ma McGraw Hill, na maua le mamalu mai le Indiana University Medical School, University of South Florida, le Mayo Medical School, le California California Society of Addiction Medicine, le Setete o Arizona, le Setete o Massachusetts, le Setete o Oregon, Province o Nova Scotia, ma le Itumalo o Alberta. Ua maua e Dr. Grant le taui e avea o se faufautua mo ofisa o tulafono i luga o mataupu e fesoʻotai ma faʻafitauli o le faʻaosoosoina o le malosi. Ua maua e Dr. Potenza se fesoasoani tau tupe poo se taui mo mea nei: faufautua mo ma se faufautua ia Boehringer Ingelheim; mea tau tupe i Somaxon; sailiiliga lagolago mai National Institutes of Health, Dept. of Veterans Affairs, Mohegan Sun Casino, National Center for Responsible Gaming ma lana Initaneti Faʻafesoʻotaʻi i Taaloga Taʻaloga, ma Laboratories Vaomatua; sa auai i suʻesuʻega, meli po o telefoni faʻatalatalanoaga e fesoʻotai ma vaisu o fualaau faasaina, faʻalavelave faʻavaivai poʻo isi mea tau soifua maloloina; ua feutagai ma ofisa o le tulafono i luga o mataupu e fesootaʻi ma vaisu po o tulaga le lelei o le pulea; ua tuʻuina atu tausiga faʻapitoa i le Connecticut Department of Health and Health Addiction Services Problem Program Services Program; ma ua fatuina tusi poʻo le tusi mataupu mo tagata talaʻi o le soifua maloloina o le mafaufau. O Dr. Weinstein ua maua ni fesoasoani suʻesuʻega mai le Israel Anti-Drug Authority, o le National Institute for Psychobiology, le Scientific Scientist o le Matagaluega o Soifua Maloloina o Isaraelu, ma le Rashi Trust (Paris, Farani) ma pili mo lauga i luga o vailaau faasaina mai le Matagaluega o Aoga a Isaraelu. Dr. Gorelick e leai ni tupe maua i fafo atu poʻo ni feteʻenaʻiga.

mau faasino

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