Abstract
Current knowledge about the neurobiological bases of substance non-medical use can rely on a growing body of literature. Nevertheless, aspects concerning chronic intoxication, psychopathological forerunners and substance-induced damage are often discussed together with the specific features of addiction, so that it may not be clear which findings and correlated features are peculiar and specific to craving and relapse proneness and which are only collateral or transient. We have tried to review the psychopathological milestones that lead from substance use to addiction while isolating the neurobiological correlates of the general diagnostic features of addiction. Our aim has been to delineate a model that will be applicable to both chemical and non-chemical addiction, but we have also tried to separate the factors that are indispensable and crucial to the development of addiction and able to account for its characteristic relapsing course, from other aspects which on close inspection turn out to be nothing more than risk factors. The insight provided by neurobiology into the psychological dynamics of addiction represents a step forward in the global understanding of addictive behaviours, which should be the basis of standard – but most likely also individualized therapeutic interventions.
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Appendix: Multiple-Choice Questions
Appendix: Multiple-Choice Questions
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1.
Craving corresponds to
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The perception of the stimulating agent
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The positive quality of stimulation (liking)
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The increase of liking for experienced drugs through time
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The abnormally urgent and overwhelming desire to stimulate oneself
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2.
The liking of a drug, which induced addiction
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Is always stronger than that of other drugs
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Is usually stronger and sharper
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Becomes highest than ever once addiction has developed
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Depends on a general reward-deficient personality
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3.
Nonaddictive craving
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Does not exist
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Does not actually make sense, although it is used to indicate amplified appetite for self-stimulation
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Is the craving for nonaddictive substances
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Is the craving for legal substances
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4.
Addiction corresponds to a brain state
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Forerunning the first contact with the drug
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Starting at the time of first drug use
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Developing during drug use
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Developing after several relapses
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5.
Addictions to different substances
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Share a similar brain-imaging profile
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Concern different brain areas
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Concern different cortical areas
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Share a similar withdrawal-related brain state
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6.
The shared ground between addictions from different substances includes
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All of the following
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Late withdrawal
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Cross-reactive craving
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Reduction of cortical inhibiting activity
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7.
The release of dopamine in the nucleus accumbens
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Is a key effect of dopaminergic drugs
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Is a key effect of heavy drugs
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Is shared by all addictive stimuli
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Is mediated by a unique specific receptor
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8.
Once addiction has established
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The effect of the substance is no longer possible
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The effect of the substance is amplified
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The expectation of the effect is amplified
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The relevance of general reward is amplified
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9.
The addictive potential of stimuli depends on
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The mechanism of action
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The legal status
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The potency
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The short latency of action
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10.
Late withdrawal
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Is not specific of addiction
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Is specific of addiction
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Is predictive of relapse
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Is a milder trail of early withdrawal
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11.
Cortical inhibitory areas
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Are underdeveloped in subject who then become addicted
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Are atrophic in addicted persons
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Are inhibited by craving-related areas
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Are not recruited effectively by addicted persons
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12.
Cueing is
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An intense recall of appetite by drug-related memories
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The subconscious recall of drug-related memories
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The persistence of drug-related memories
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The recall of affectively relevant drug-related memories
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13.
The objective of anticraving treatment is
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To suppress the desire for the drug
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To normalize craving to normal desire
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To suppress the urgency to get the drug
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To suppress the fear of withdrawal
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14.
Craving during withdrawal
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Is basically due to the fear of withdrawal
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Is basically due to the increase of appetition
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Is the irresistible component of craving
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Is the core component of craving
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15.
Non-chemical addictions
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Are not true addictions
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Share similar biological features with chemical addictions
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Are not chemically mediated, but psychologically
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Are a side aspect of certain psychiatric disorders
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16.
The psychiatric syndrome closely resembling addiction is
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Mania
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Depression
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Panic
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Personality disorders
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17.
The best fitting model of addictive diseases can be identified in
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A general neurotransmitter deficiency
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Subcortical plastic changes in some input areas, affecting substance effects
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Subcortical plastic changes in some feedback areas, affecting substance-seeking behaviour
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A cortical area
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18.
Opiate withdrawal has a relevant biological overlap with
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Depression
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Panic attacks
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Mania
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Obsessive-compulsive disorder
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19.
Relapse differs from a simple new-use episode
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The brain reacts differently to the substance and starts back from the addictive stage
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The substance is the same
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Doses are higher
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The brain is still under withdrawal when relapsing
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20.
The most effective mechanisms against craving are
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Motivational treatment
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Blockade of the substance’s effects
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Direct receptor-mediated reduction of baseline craving
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The coupling between the previous two
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Maremmani, I., Pacini, M., Fountoulakis, K.N. (2019). Psychobiology of Addictions. In: Fountoulakis, K., Nimatoudis, I. (eds) Psychobiology of Behaviour. Springer, Cham. https://doi.org/10.1007/978-3-030-18323-3_7
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