Addiction denial and cognitive dysfunction: a preliminary investigation

This study explored the proposition that denial of addiction is often more a product of cognitive failure due to cerebral dysfunction than an emotion-driven rejection of the truth. Forty-four subjects were studied in an inpatient alcohol rehabilitation program. Denial was defined as the proportion of standardized denial-related treatment goals established at admission that remained unachieved at discharge. Cognitive deficiencies were identified through neuropsychological assessments. Persistent denial was significantly correlated with greater impairment of executive function, verbal memory, visual inference, and mental speed.     

Investigative empathy: a strength scale of empathy based on European police perspectives

A growing body of research suggests that empathy plays a major role in establishing and maintaining rapport during police interviews. The benefits of rapport include not only increased cooperation from interviewees, but also gaining more accurate investigation-relevant information. However, there still is no universally agreed-upon definition and very little research on operationalizing empathy, especially within investigative interviewing. The present study analyzed police interviewers’ self-reports regarding their (a) training and methods employed during interviews, (b) application of empathy in interviews, and (c) definitions/understanding of empathy. It was found that officers in all seven participating countries varied within each country in their use of accusatory or information-gathering interview styles. The majority of participants in each country claimed to employ empathy in their interviews with suspects, yet they varied regarding the definitions they provided. In no country was empathy defined as having aspects that may not be conducive to investigative interviewing.     

Addiction: a disease of learning and memory

If neurobiology is ultimately to contribute to the development of successful treatments for drug addiction, researchers must discover the molecular mechanisms by which drug-seeking behaviors are consolidated into compulsive use, the mechanisms that underlie the long persistence of relapse risk, and the mechanisms by which drug-associated cues come to control behavior. Evidence at the molecular, cellular, systems, behavioral, and computational levels of analysis is converging to suggest the view that addiction represents a pathological usurpation of the neural mechanisms of learning and memory that under normal circumstances serve to shape survival behaviors related to the pursuit of rewards and the cues that predict them. The author summarizes the converging evidence in this area and highlights key questions that remain.     

Addiction and the Concept of Disorder,Part 1: Why Addiction is a Medical Disorder

In this two-part analysis, I analyze Marc Lewis’s arguments against the brain-disease view of substance addiction and for a developmental-learning approach that demedicalizes addiction. I focus especially on the question of whether addiction is a medical disorder. Addiction is currently classified as a medical disorder in DSM-5 and ICD-10. It is further labeled a brain disease by NIDA, based on observed brain changes in addicts that are interpreted as brain damage. Lewis argues that the changes result instead from normal neuroplasticity and learning in response to the intense rewards provided by addictive substances, thus that addiction is not a brain disease and by implication not a medical disorder at all. I argue that even if one accepts Lewis’s reinterpretation of the brain evidence, his conclusions do not follow. Relying on my harmful-dysfunction analysis of medical disorder, I defend the view that substance addiction is in fact a medical disorder and a brain disorder. In Part 1, I identify five arguments Lewis puts forward against the brain-disease view and evaluate them as arguments that addiction is not a disorder: (1) Addiction is not a chronic, relapsing condition; (2) There is no clear boundary between addiction and other strong desires; (3) Negative consequences are not unique to disorders; (4) The brain disease model does not account for behavioral addictions; and, (5) Addiction is like love. I argue that Lewis’s arguments are invalid because they fail to take account of the context of addiction and its relation to biological design.     

Enhancing partner empathy and support in the postnatal period: impact of a communication and empathy resource on sub-optimal communicators

Postnatal distress in women is often associated with poor partner support or understanding, often as a result of poor couple communication. Previous research showed positive findings for an innovative resource aimed to ameliorate these factors in community couples – ‘The Great Parents' Quiz’ (GPQ). This current study compared the impact of this resource on couples classified as either ‘good communicators’ or ‘sub-optimal communicators’ prior to receiving the GPQ. A between and within research design was used. Parents of infants and toddlers (N = 167) were randomly allocated to either receiving the GPQ or not (Controls). Phone interviews were conducted with the women 2 weeks and 6 weeks after receiving the GPQ, or just at 6 weeks for Control participants. Both good and sub-optimal communicators showed equivalent benefits from receiving the GPQ. Around 81% of sub-optimal communicators reported that one or other of the couple had learnt something new about their partner, and 66% of the women considered that their partner had a better understanding of how she was experiencing motherhood. In total, 28% of sub-optimal communicators reported new supportive behaviour as a result of doing the GPQ, and this tended to be proactive as opposed to couples in the Control condition who reported changes as a result of intolerable stress. Both good and sub-optimal communicators report clinically significant benefits from doing the GPQ, and these benefits are more than those obtained from the usual pamphlets giving advice to couples to ‘talk and listen’ to each other.     

Motor functioning in autistic spectrum disorders: a preliminary analysis

The study sought to identify differences in motor functioning between autism and Asperger syndrome while also assessing the diagnostic contribution of such assessment. A sample of 16 individuals with autism and 10 with Asperger syndrome completed the Dean-Woodcock Sensory-Motor Battery, and outcomes were compared. Significant differences were found in measures of cerebellar functioning, favoring Asperger subjects. Deficits in coordination, ambulation, and the Romberg test were associated with both disorders. On the basis of motor outcomes alone, 100% were accurately differentiated. Findings support the idea that motor dysfunction is a core feature of these presentations and demonstrated the utility of motor assessment in diagnostic practice.     

"Denkfaulheit" in frontotemporal dementia: a preliminary analysis

The initial recognition of frontotemporal dementia is often difficult. Frontotemporal dementia presents with subtle personality changes in the absence of a definitive biomarker. The authors report an analysis of cognitive shallowness, or "Denkfaulheit," in patients with frontotemporal dementia early in its course.     

Behavioral design of a positive verbal community: a preliminary experimental analysis

Behaviorists have theorized (and experimental analyses suggest) the potential clinical application of verbal behavior modification. This study evaluated therapeutic effects of behavioral intervention to modify the intact verbal community. The setting was an adolescent operant treatment center for behavioral disorders. All residents within the center, 16 females and 22 males, participated in the study. A within subjects experimental design compared effects of a positive verbal community (PVC) plus the ongoing operant treatment program to the operant program alone. Conceptually, these were dual-level and single-level operant programs, respectively. Dependent measures included rates of positive goal-relevant verbalizations of residents, and clinical measures of self-control and psychiatric symptoms. Preliminary evidence supported the feasibility of the PVC as a potential novel therapeutic intervention.     

Is Mobile Addiction a Unique Addiction: Findings from an International Sample of University Students

This research explores whether addictions around mobile phones should be treated more as a physiological or a psychological problem. A new survey about mobile addiction and time use (MATU), constructed from several studies, tests to what degree time use on mobile phones (a physiological cause) is correlated with four behavioral factors predicting proneness to addiction, respectively one physiological problem and three psychological problems: sensation seeking, impulsiveness, anxiety, and hopelessness. Equally, an index on how strongly students interpret that they have a mobile addiction problem was tested for whether it was correlated to the same four factors. A sample of 1219 students was drawn from four universities, three in the USA and one in South Korea. Correlations between six indexes were analyzed. Students who think they have a “mobile phone time use problem” do not report high (physiological) sensation seeking at all (0.18, p < 0.01) yet have higher correlations only with three psychological problems: impulsiveness (0.64, p < 0.01), hopelessness (0.47, p < 0.01), and anxiety (0.31, p < 0.01). On the other hand, the exact inverse occurs among actual sensation seekers with high time use (0.85, p < 0.01) who lack high correlations with three psychological problems (each below 0.15, p < .01). The pattern held across four different universities and two countries with minimal variations. Mobile addictions appear to be two different types of individualized problems instead of one: physiological problems for some (without major psychological problems) and psychological problems for others (without high time use). This research may help influence policy to target different individual problems in mobile addiction.

     

Addiction and Moralization: the Role of the Underlying Model of Addiction

Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction.     

Barriers and Facilitators of Addiction Treatment: a Qualitative Study

International Journal of Mental Health and Addiction - Addictive disorders affect a considerable proportion of the population worldwide and in India. Treatment-related barriers and facilitators...     

“Internet Addiction”: a Conceptual Minefield

With Internet connectivity and technological advancement increasing dramatically in recent years, “Internet addiction” (IA) is emerging as a global concern. However, the use of the term ‘addiction’ has been considered controversial, with debate surfacing as to whether IA merits classification as a psychiatric disorder as its own entity, or whether IA occurs in relation to specific online activities through manifestation of other underlying disorders. Additionally, the changing landscape of Internet mobility and the contextual variations Internet access can hold has further implications towards its conceptualisation and measurement. Without official recognition and agreement on the concept of IA, this can lead to difficulties in efficacy of diagnosis and treatment. This paper therefore provides a critical commentary on the numerous issues of the concept of “Internet addiction”, with implications for the efficacy of its measurement and diagnosticity.