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Background and aims
Compulsive sexual behavior (CSB) is a common behavior affecting 3–6% of the population, characterized by repetitive and intrusive sexual urges or behaviors that typically cause negative social and emotional consequences.
Methods
For this small pilot study on neurological data, we compared 13 individuals with CSB and gender- matched healthy controls on diagnostic assessments and computerized neurocognitive testing.
Results
No significant differences were found between the groups.
Conclusions
These data contradict a common hypothesis that CSB is cognitively different from those without psychiatric comorbidities as well as previous research on impulse control disorders and alcohol dependence. Further research is needed to better understand and classify CSB based on these findings.
Background and aims
Compulsive sexual behavior (CSB) is a common disorder featuring repetitive, intrusive and distressing sexual thoughts, urges and behaviors that negatively affect many aspects of an individual’s life. This article reviews the clinical characteristics of CSB, cognitive aspects of the behaviors, and treatment options.
Methods
We reviewed the literature regarding the clinical aspects of CSB and treatment approaches.
Results
The literature review of the clinical aspects of CSB demonstrates that there is likely a substantial heterogeneity within the disorder. In addition, the treatment literature lacks sufficient evidence-based approaches to develop a clear treatment algorithm.
Conclusions
Although discussed in the psychological literature for years, CSB continues to defy easy categorization within mental health. Further research needs to be completed to understand where CSB falls within the psychiatric nosology.
Background and aims
Epidemiological data have suggested that the prevalence of co-occurring personality disorders is particularly high in people with gambling disorder (GD). Among the personality disorders, obsessive–compulsive personality disorder (OCPD) appears to be the most common problem. The objective of this study was to investigate the clinical presentation of GD with and without co-occurring OCPD.
Methods
We studied 25 subjects with current GD and lifetime diagnosis of OCPD. They were matched for age and gender with 25 individuals with current GD but no lifetime diagnosis of any personality disorder.
Results
Subjects with GD and OCPD demonstrated (a) lower severity of gambling symptoms, (b) slower progression from recreational gambling to full-blown GD, (c) preferred individual forms of betting, (d) identified more triggers to gambling (specially the availability of money and stress); and (e) reported less negative impact on relational problems due to GD.
Conclusions
Our research provides further insight on GD co-occurring with OCPD, such as increasing social support and improvement of coping skills, especially to deal with financial difficulties and stress. Our findings may lead to more customized and effective therapeutic approaches to this frequent comorbidity.
Background and aims
Although inadequate sleep has been linked to problematic behaviors, such as poor impulse control and emotion dysregulation, little research interest has been the role of sleep and sleep deprivation on impulsive behaviors in young adults. To further examine the relationship of sleepiness to impulsivity and impulsive behaviors, this study was designed to collect data on sleepiness, and a range of impulse control disorders and cognitive measures.
Methods
Young non-treatment-seeking adults were recruited from two US cities and completed a screening form for sleepiness, along with demographic, clinical, and cognitive measures relevant to impulsivity. Relationships between these explanatory variables and total sleepiness scores were analyzed using partial least squares. Significant explanatory variables were identified (p < .05, bootstrap).
Results
Higher levels of sleepiness were significantly associated with higher ADHD symptoms, gambling disorder symptoms, Internet addiction symptoms, and personality-related impulsiveness. Sleepiness was also associated with set-shifting errors, and with gambling more points (abnormal decision-making), but not with significant impairment in response to inhibition, or other aspects of decision-making.
Conclusions
This study confirms a cross-sectional relationship between sleepiness and a range of impulsive measures at the level of behavior (ADHD, gambling, and Internet addiction) and personality traits. Longitudinal research would be required to explore causal mechanisms and the direction of any such effects. Screening for such mental health diagnoses in people with sleep problems may be valuable, as enquiring patients with such impulsive symptoms about sleep, in order to maximize quality of life.
Abstract
Background
Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive family history means for people who gamble in the general community. We sought to understand the clinical and cognitive impact of having a first-degree relative with a substance use disorder (SUD) in a sample of non-treatment seeking young adults.
Methods
576 participants (aged 18–29 years) who gambled at least five times in the preceding year undertook clinical and neurocognitive evaluations. Those with a first-degree relative with a SUD were compared to those without on a number of demographic, clinical and cognitive measures. We used Partial Least Squares (PLS) regression to identify which variables (if any) were significantly associated with family history of SUDs, controlling for the influence of other variables on each other.
Results
180 (31.3%) participants had a first-degree family member with a SUD. In terms of clinical variables, family history of SUD was significantly associated with higher rates of substance use (alcohol, nicotine), higher rates of problem gambling, and higher occurrence of mental health disorders. Family history of SUD was also associated with more set-shifting problems (plus higher rates of obsessive-compulsive tendencies), lower quality of decision-making, and more spatial working memory errors.
Conclusions
These results indicate that gamblers with a first-degree family member with a SUD may have a unique clinical and cognition presentation. Understanding these differences may be relevant to developing more individualized treatment approaches for disordered gambling. Compulsivity may be important as a proxy of vulnerability towards addiction.
Abstract
Background
Adolescent shoplifting occurs in an estimated 15% of the United States population. Although adolescent stealing is associated with significant psychosocial consequences there is limited research concerning efficacious treatments.
Case study
A 17-year-old male with a history of compulsive stealing was treated using a six-session, individualized cognitive-behavioral therapy protocol which included motivational interviewing, psycho-education, behavioral modification, and an exposure script using imaginal desensitization. After the six-session therapy, the patient continued for eight further sessions of therapy to maintain treatment gains. His Yale-Brown Obsessive Compulsive Scale scores dropped from a 22 pre-treatment to a 3 at the end of the 14 sessions of therapy and he remained abstinent from stealing.
Discussion
This case reports on the successful use of an individualized, cognitive behavioral therapy on an adolescent with compulsive shoplifting and other antisocial behaviors. This treatment provides a promising step towards the treatment of a relatively common adolescent behavior.
Abstract
Background and aims
Binge eating disorder (BED) is a relatively common condition, especially in young adult females, and is characterized by chronic over-consumption of food resulting in embarrassment, distress, and potential health problems. It is formally included as a disorder in DSM-5 for the first time, an acknowledgement to its debilitating nature. This article explores the overlap between binge eating disorder and substance use disorders (SUD).
Methods
The bibliographic search was a computerized screen of PubMed databases from January 1990 to the present. Binge eating disorder, substance use disorder, binging, obesity, food addiction, comorbidity, dopamine, opioid, serotonin, glutamate, and pharmacological treatment were the keywords used in searching.
Results
BED shares similar phenomenology to SUD, including significant urges to engage in binging episodes, resulting in distress and impairment. Similar neurobiological pathways are found in both BED and SUD and medications based on similar neurobiology have been examined for both disorders. A subset of individuals with BED may have a “food addiction”, but there is no clinical agreement on the meaning of “food addiction”. Exploring the relationship between BED and obesity may also shed light on the extent to which BED can be viewed as an addiction.
Conclusions
Overall, nascent research regarding BED and SUD suggests an overlap between these disorders, but there are discrepancies between these two disorders that need further exploration.
Background and aims
Problematic Internet use (PIU) is commonplace but is not yet recognized as a formal mental disorder. Excessive Internet use could result from other conditions such as gambling disorder. The aim of the study was to assess the impact of impulsive–compulsive comorbidities on the presentation of PIU, defined using Young’s Diagnostic Questionnaire.
Methods
A total of 123 adults aged 18–29 years were recruited using media advertisements, and attended the research center for a detailed psychiatric assessment, including interviews, completion of questionnaires, and neuropsychological testing. Participants were classified into three groups: PIU with no comorbid impulsive/compulsive disorders (n = 18), PIU with one or more comorbid impulsive/compulsive disorders (n = 37), and healthy controls who did not have any mental health diagnoses (n = 67). Differences between the three groups were characterized in terms of demographic, clinical, and cognitive variables. Effect sizes for overall effects of group were also reported.
Results
The three groups did not significantly differ on age, gender, levels of education, nicotine consumption, or alcohol use (small effect sizes). Quality of life was significantly impaired in PIU irrespective of whether or not individuals had comorbid impulsive/compulsive disorders (large effect size). However, impaired response inhibition and decision-making were only identified in PIU with impulsive/compulsive comorbidities (medium effect sizes).
Discussion and conclusions
Most people with PIU will have one or more other impulsive/compulsive disorders, but PIU can occur without such comorbidities and still present with impaired quality of life. Response inhibition and decision-making appear to be disproportionately impacted in the case of PIU comorbid with other impulsive/compulsive conditions, which may account for some of the inconsistencies in the existing literature. Large scale international collaborations are required to validate PIU and further assess its clinical, cognitive, and biological sequelae.
Background
Pyromania is a rare disorder that is characterized by multiple episodes of deliberate and purposeful fire-setting. It is typically associated with significant psychosocial dysfunction and legal problems. Even so, little research has examined cognitive aspects of the disorder.
Case presentation/study
In this study, we compared a 24-year-old woman with pyromania with 19 age- and gender-matched healthy controls using a battery of computerized neurocognitive tasks. Our participant affected by pyromania showed impaired cognitive flexibility but intact functioning on measures of impulsive action and decision-making.
Discussion
Although pyromania shares phenomenological similarities with other urge-driven disorders, our results suggest that pyromania may have features of compulsivity as well.
Conclusions
Pyromania is relatively understudied from a neurobiological perspective. Further research is needed to understand the pathophysiology, classification, and treatment of pyromania.
Background
This study sought to examine the occurrence of the problematic use of smartphones in a university sample and associated physical and mental health correlates, including potential relationships with risky sexual practices.
Methods
A 156-item anonymous online survey was distributed via e-mail to a sample of 9,449 university students. In addition to problematic smartphone usage, current use of alcohol and drugs, psychological and physical status, and academic performance were assessed.
Results
A total of 31,425 participants were included in the analysis, of whom 20.1% reported problematic smartphone use. Problematic use of smartphones was associated with lower grade point averages and with alcohol use disorder symptoms. It was also significantly associated with impulsivity (Barratt scale and ADHD) and elevated occurrence of PTSD, anxiety, and depression. Finally, those with current problems with smartphone use were significantly more sexually active.
Conclusions
Problematic use of smartphones is common and has public health importance due to these demonstrable associations with alcohol use, certain mental health diagnoses (especially ADHD, anxiety, depression, and PTSD), and worse scholastic performance. Clinicians should enquire about excessive smartphone use as it may be associated with a range of mental health issues. Research is needed to address longitudinal associations.
