Conradi-Hünerman-Happle Syndrome and Obsessive-Compulsive Disorder: a clinical case report.

BACKGROUND: Obsessive-Compulsive Disorder (OCD) is a common and chronic psychiatric disorder with significant morbidity characterized by intrusive, uncontrollable and reoccurring thoughts (i.e., obsessions) and/or ritualistic behaviours (i.e., compulsions). Conradi-Hünerman-Happle Syndrome (CHHS) is a rare inherited X-linked dominant variant of chondrodysplasia punctata, a heterogeneous group of rare bone dysplasias characterized by punctate epiphyseal calcifications of complex etiology and pathophysiology that remain to be defined. Available literature reveals a lacuna in regards to the coexistence of the entities with no clinical reports described. CASE PRESENTATION: A 12 year old female patient with diagnosis of CHHS, presents to psychiatric consultation due to aggravation of her OCD clinical picture, with aggravation of hand-washing frequency during the Covid-19 pandemic with significant functional impact. Psychopharmacological treatment aimed at OCD with Selective Serotonin Reuptake Inhibitor (SSRI) and antipsychotic was instituted with favourable, albeit partial response. CONCLUSIONS: The authors aim to describe a clinical case in which the patient presents with Conradi-Hünerman-Happle Syndrome and Obsessive-Compulsive Disorder. Clinical descriptions of CHHS and OCD are not available in the literature. Through this case description the authors aim to present a rare case as well as discuss an eventual association between etiology and/or pathophysiology of the two disorders.

Uma leitura metapsicológica sobre a compulsão à repetição e suas potencialidades terapêuticas / Las potencialidades terapéuticas inscritas en la compulsion a la repetición y algunas justificaciones metapsicologicas / A metapsychological analisis about the compulsion towards repetition and its therapeutic potentialities

RESUMO Fenômenos associados à compulsão à repetição apresentam-se na clínica psicanalítica como reveladores de uma dor da qual o paciente nada sabe dizer, mas que se impõe como um destino implacável. Partilhando da opinião de alguns psicanalistas sobre as potencialidades terapêuticas inscritas na compulsão à repetição e cientes das dificuldades que envolvem a sua justificação teórica, este artigo busca aclarar a trama conceitual da metapsicologia que pode vir a embasar tal compreensão. Desse modo, partindo de uma pesquisa conceitual, objetivamos explicitar os fenômenos metapsicológicos que estão inscritos na repetição, propiciando uma releitura de aspectos importantes da obra freudiana. Assim, o artigo desenvolve a ideia de que as energias disruptivas presentes na compulsão à repetição, ao serem submetidas ao trabalho de ligação realizado pelo 'Eu', um processo secundário por excelência, articulado às noções de fusão e desfusão pulsionais, presentes em textos da etapa madura das reflexões de Freud, permite lançar alguma luz sobre processos obscuros subjacentes aos fenômenos em tela.

RESUMEN Fenómenos asociados a la compulsión a la repetición se presentan en la clínica psicoanalítica como reveladores de un dolor del cual el paciente nada sabe decir, pero que se impone como un destino implacable. Compartiendo la opinión de algunos psicoanalistas en las potencialidades terapéuticas inscritas en la repetición y conscientes de las dificultades que envuelven su justificación teórica, este artículo busca explicitar la trama conceptual metapsicológica que puede venir a embasar su comprensión. Así, empiezando desde una búsqueda conceptual, tenemos como objetivo demuenstrar a los fenómenos metapsicológicos que se encuentran inscritos en la repetición, proporcionando una reinterpretación de importantes aspectos de la obra de Freud. Por lo tanto, este articulo desarrolla la idea de energías disruptivas encuentradas en la compulsión hacia la repetición cuando se las envían al trabajo de ligación realizado por el 'Yo', un procedimiento secundario por excelencia, enlazados a la comprensión de fusión y desfusion pulsionales, que están presentes en textos de la etapa madura de las relfexiones de Freud, permitiendo tirar alguna luz sobre procesos oscuros subyacentes a los fenómenos en discusión.

ABSTRACT Phenomena associated with repetition compulsion appear in the psychoanalytic clinic revealing a pain the patient knows nothing about, but which imposes as a relentless fate. Sharing the opinion of some psychoanalysts about therapeutic potentialities inscribed in the compulsion repetition and aware of the difficulties involved in their theoretical justification, this article sought to explain the conceptual framework necessary to understand the process underlying such phenomena. Thus, starting from a conceptual research, we aimed to explain the metapsychological phenomena inscribed in repetition, providing a new understanding of important aspects of the Freudian work. Therefore, the article develops the idea that disruptive energies present in repetition compulsion when subjected to connection carried out by the 'Self', a secondary process par excellence, articulated to the notions of drive fusion and defusion, available in texts from the mature stage of Freud's reflections, allows to shed light on obscure processes underlying the phenomena in question.

Evidence of validity, reliability and psychometric parameters of the items of the Cognitive Emotion Regulation Questionnaire-Short (CERQ-Short) / Evidência de validade, fidedignidade e parâmetros psicométricos dos itens do Questionário Cognitivo de Regulação Emocional-Short (CERQ-Short) / Evidencia de validez, fidedignidad y parámetros psicométricos de los ítems del Cuestionario Cognitivo de Regulación Emocional-Short (CERQ-Short)

The aim of the present study was to evaluate the construct validity, internal consistency and psychometric indicators of the reduced version of the Cognitive Emotion Regulation Questionnaire (CERQ-short). The CERQ-short was adapted and translated to Portuguese prior to its administration to 254 adults, mainly from the state of Paraíba, Brazil. The Difficulties in Emotion Regulation Scale (DERS), the Compulsive Buying Scale (CBS) and a sociodemographic questionnaire were also applied. The original CERQ-short nine-factor structure was preserved. The convergent and discriminant validity, the reliability and the psychometric adequacy concerning item difficulty and item discrimination were also confirmed. The results support the use of this scale for rapid screening and research. (AU)

O presente estudo teve como objetivo buscar evidências de validade de construto, de consistência interna e indicadores psicométricos dos itens da versão adaptada para o português do Questionário Cognitivo de Regulação Emocional versão reduzida (CERQ-short). Após tradução e adaptação, foi aplicado o CERQ-Short, as escalas de dificuldade em regulação emocional (DERS) e de Compras Compulsivas (CBS), além de um questionário demográfico em uma amostra de 254 adultos, maioria de paraibanos. Verificou-se que a estrutura original de nove fatores do CERQ-Short foi mantida, também foram confirmadas as validades convergente e discriminante, a fidedignidade e a adequação psicométrica dos itens no que se refere à dificuldade e à discriminação dos itens. A escala apresentou evidência para a utilização em rastreio rápido e pesquisas. (AU)

El presente artículo tuvo como objetivo la búsqueda de evidencias de la validez del construto e indicadores psicométricos de los ítems, de una versión adaptada para el portugués, del Cuestionario Cognitivo de Regulación Emocional, versión reducida (CERQ-short). Inicialmente, fue realizada la traducción y adaptación semántica; posteriormente, fue aplicado el cuestionario CERQ-Short a las escalas de dificultad en regulación emocional (DERS) y de las Compras Compulsivas (CBS), además de un cuestionario demográfico en una muestra de 254 adultos, la mayoría de los paraibanos. Se verificó que la estructura original de nueve factores del CERQ-Short fue mantenida, así como las evidencias de validez del construto, fiabilidad y adecuación psicométrica de los ítems. La escala presentó evidencias para la utilización en rastreo rápido y pesquisas. (AU)

Validity evidences of the Buying Impulsiveness Scale in the Brazilian context / Evidências de validade da Escala de Compra por Impulso para o contexto brasileiro / Evidencias de validez de Escala de Compras por Impulso en el contexto brasileño

The objective of this study was to obtain evidence of validity of an instrument to measure the tendency to buy impulsively. A version adapted to Brazil of a Buying Impulsiveness Scale was applied to 1296 Brazilians from all states of the federation, with a mean age of 35.8 years (SD = 12.8). The results indicated a scale with one-factor structure, just like the original instrument, with an adequate index of internal consistency. Positive correlations were found between impulse buying tendency, normative social influence, and traits of impulsiveness of the consumer. The instrument was also able to differentiate people who make shopping lists from those who do not do them, and people who prefer to go shopping alone from those who prefer to buy accompanied by someone else. The evidences found in the study provide support to the use of the instrument for the Brazilian context. (AU)

O objetivo deste estudo foi buscar evidências de validade de um instrumento para aferir a tendência de comprar impulsivamente. Aplicou-se uma versão adaptada para o Brasil de uma escala de compra por impulso em 1.296 brasileiros de todos os estados da federação, média de idade de 35,8 anos (DP = 12,8). Os resultados indicaram uma escala com estrutura unifatorial, tal como o instrumento original, com adequado índice de consistência interna. Foram encontradas correlações positivas entre a tendência de comprar por impulso, a influência social normativa e traços de impulsividade do consumidor. O instrumento também foi capaz de diferenciar pessoas que fazem lista de compras das que não fazem e pessoas que preferem ir às compras sozinhas das que preferem comprar acompanhadas. As evidências encontradas suportam o uso do instrumento para o contexto brasileiro. (AU)

El objetivo de este estudio fue buscar evidencias de validez de un instrumento para medir la tendencia de comprar impulsivamente. Se aplicó una versión adaptada para Brasil de una escala de compra por impulso en 1296 brasileños de todos los estados del país, con promedio de edad de 35,8 años (DP = 12,8). Los resultados indicaron una escala con estructura unifactorial, tal como el instrumento original, con adecuado índice de consistencia interna. Se encontraron correlaciones positiva entre tendencia de comprar por impulso, influencia social normativa y rasgos de impulsividad del consumidor. El instrumento también fue capaz de diferenciar personas que hacen lista de compras de las que no hacen, y personas que prefieren ir de compras solas de las que prefieren ir acompañadas. Las evidencias encontradas apoyan el uso del instrumento en el contexto brasileño. (AU)

Orthorexia: eating right in the context of healthism.

Orthorexia is a putative new eating disorder vying for a place in the DSM, roughly meaning "eating right". While a continuum can be drawn between anorexia and orthorexia, there are enough differences to make this disorder a distinct one. In this paper, I trace the origins of the term and its clinical career to date, employing Ian Hacking's concept of "ecological niche" to establish the place of orthorexia as a contemporary cyberpathy, a digitally transmitted disorder inwardly and narrowly focused on health through the consumption of "pure" foods. I critique both the notions of "health" and "purity" in this context, showing that orthorexia can only be understood in the context of healthism, an individual preoccupation with health in the context of neoliberalism. Using Jordan Younger's Breaking Vegan memoir (2015) and "Balanced Blonde" blog as a case study, I argue that orthorexia replicates via a digital proliferation of entrepreneurship of the self. Ultimately, this excessive preoccupation with health as a neoliberal cultural pathology bares life of meaning.

Lower nucleus accumbens α-synuclein load and D3 receptor levels in Parkinson's disease with impulsive compulsive behaviours.

Impulsive compulsive behaviours in Parkinson's disease have been linked to increased dopaminergic release in the ventral striatum and excessive stimulation of dopamine D3 receptors. Thirty-one patients with impulsive compulsive behaviours and Parkinson's disease who donated their brains to the Queen Square Brain Bank for Neurological Disorders were assessed for α-synuclein neuropathological load and tyrosine hydroxylase levels in the nucleus accumbens, dorsal putamen and caudate using immunohistochemistry. Dopamine D2 and dopamine D3 receptors protein levels in the nucleus accumbens, frontal cortex and putamen were determined using western blotting. Results were compared to 29 Parkinson's disease cases without impulsive compulsive behaviours matched by age, sex, disease duration, age at Parkinson's disease onset and disease duration. The majority of patients with impulsive compulsive behaviours had dopamine dysregulation syndrome. Patients with Parkinson's disease and impulsive compulsive behaviours had lower α-synuclein load and dopamine D3 receptor levels in the nucleus accumbens. No differences were seen between groups in the other brain areas and in the analysis of tyrosine hydroxylase and dopamine D2 receptor levels. Lower α-synuclein load in the nucleus accumbens of individuals with Parkinson's disease and impulsive compulsive behaviours was confirmed on western blotting. Downregulation of the dopamine D3 receptor levels may have occurred either as a consequence of the degenerative process or of a pre-morbid trait. The lower levels of α-synuclein may have contributed to an excessive stimulation of the ventral striatum resulting in impulsive compulsive behaviours.

Personality beliefs as a predictor of smartphone addiction

Objective The purpose of this study is to determine the relation between smart phone addiction and personality beliefs of university students. Methods A total of 1007 students, 637 females (63.3%) and 370 males (36.7%) participated in the study. "Smart phone addiction scale short form" was used to measure smart phone addiction and "personality beliefs scale" was used to identify personality beliefs. Results According to the performed multiple regression analysis, it was found out that dependent, antisocial, narcissist, histrionic, borderline, paranoid personality, schizoid personality, obsessive compulsive personality, passive-aggressive personality and avoidant personality beliefs predicted smart phone addiction at significant level (R = 0.38, R2 = 0.15, p < 0.001). The mentioned variables explain 15% of the variance. An examination of the t-test shows that dependent personality (t = 5.585, p < 0.001), passive-aggressive personality (t = -4.485, p < .001) and paranoid personality (t = 2.901, p < .01) belief among the mentioned variables are a significant predictor of smart phone addiction. Discussion The obtained results show that dependent, passive-aggressive and paranoid personality beliefs are a significant predictor of smart phone addiction. Research findings are discussed in the light of relevant literature.

Skin picking in patients with obesity: Associations with impulsiveness and self-harm.

Previous studies suggest elevated prevalence rates of skin picking and self-harm in patients with obesity compared to individuals in the general population. Hence, further studies should investigate prevalence rates and correlates of skin picking in this population - especially its differentiation to self-harm. Skin picking and obesity are both associated with specific facets of impulsiveness. This relation should be explored to shed light on potentially shared mechanisms in etiology. Therefore, the present study examined the occurrence of skin picking and its associations with impulsiveness and self-harm in a sample of pre-bariatric surgery patients with obesity class II/III. Within the routine preoperative psychiatric evaluation, a total of 139 bariatric surgery candidates (78% female, BMI range 35-69) completed a self-report questionnaire assessing sociodemographic variables, anxiety, depression, self-harm, impulsiveness, and skin picking severity (urges: frequency, intensity, controllability; behavior: frequency, intensity, controllability; resistance, emotional distress, impairment, and avoidance). Ten participants (7.2% of the sample) reported recurrent skin picking leading to skin damage, repeated attempts to decrease skin picking, and psychosocial impairment (emotional distress, impairment in functional areas, avoidance) due to skin picking. In line with previous findings, skin picking severity shows a medium correlation with attentional impulsiveness. The majority of self-harm types were not associated with skin picking severity. The current study reveals a high occurrence of skin picking compared to the general population. The results indicate an association between skin picking severity and attentional impulsiveness. Further research is needed to investigate the differentiation of skin picking and self-harm in more detail.

A Systematic Meta-Review of Impulsivity and Compulsivity in Addictive Behaviors.

It is well established that poor inhibitory control confers both a vulnerability to, and maintenance of, addictive behaviors across the substance and behavioral spectrums. By comparison, the role of compulsivity in addictive behaviors has received less research focus. The neurocognitive literature to date is vast, and it is unclear whether there are any convincing lines of systematic evidence delineating whether and how aspects of impulsivity and compulsivity are shared and unique across different substance and behavioral addictive disorders. Such information has significant implications for our understanding of underlying mechanisms and clinical implications for assessing and treating neurocognitive deficits across addictions. Here, we conducted a systematic meta-review of the quantitative meta-analyses to date, specifically examining the neurocognitive functions central to impulsive-compulsive behaviors transdiagnostically across addictive behaviors. Out of 1186 empirical studies initially identified, six meta-analyses met inclusion criteria examining alcohol, cannabis, cocaine, MDMA, methamphetamine, opioid and tobacco use, as well as gambling and internet addiction. The pooled findings across the systematic meta-analyses suggest that impulsivity is a core process underpinning both substance and behavioral addictive disorders, although it is not equally implicated across all substances. Compulsivity-related neurocognition, by comparison, is important across alcohol and gambling disorders, but has yet to be examined systematically. The gestalt of findings to date suggests that both impulsivity and compulsivity are core constructs linked to addictive behaviors and may not be solely the secondary sequelae associated with the effects of prolonged substance exposure.

Screening for Problematic Internet Use May Help Identify Impulse Control Disorders in Parkinson's Disease.

BACKGROUND: Impulse control disorders in Parkinson's disease (PD) represent emerging problems with potentially devastating consequences. The standard screening methods for impulse control disorders are clinically imperfect. Although it is rarely reported, many patients utilize the Internet to fulfill their compulsive behaviors because of its easy accessibility. We designed a study to test the hypothesis that an active screening for excessive Internet use and Internet addiction might improve the sensitivity of identification of impulse control disorders. METHODS: The standard screening method included the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease and the modified Minnesota Impulsive Disorders Interview. In the second round, the Problematic Internet Use Questionnaire was also assessed for detecting excessive Internet use. RESULTS: While the standard approach identified 19 patients out of 106 (17.9%) with any type of impulse control disorders, screening for the problematic Internet use detected 29 patients with impulse control disorders (27.4%) having significantly better efficacy over the standard method (p = 0.004, the McNemar test). CONCLUSIONS: Our study suggests that the screening for problematic Internet use by the Problematic Internet Use Questionnaire is an effective, feasible, and easy-to-use add-on method for identifying PD patients with impulse control disorders more efficiently and probably at earlier stages.

Mental Contamination in Obsessive-Compulsive Disorder: Associations With Contamination Symptoms and Treatment Response.

The most common symptom of obsessive-compulsive disorder (OCD) is contamination fear. Feelings of contamination can be provoked through contact with a physical contaminant, referred to as contact contamination (CC), as well as in the absence of one, referred to as mental contamination (MC). Prior research indicates that CC and MC are distinct, and MC may interfere with treatment for CC. However, no study to date has examined how MC may be associated with responses to physical contaminants and treatment response for CC. This study examined the relationships between CC and MC in a sample of individuals with elevated contamination symptoms (N = 88), half of whom met diagnostic criteria for OCD. Participants engaged in three sessions of exposure and response prevention (ERP) for CC and completed self-report measures and behavioral tasks assessing CC and MC at pretreatment, posttreatment, and follow-up. As hypothesized, at pretreatment, MC was positively associated with reactivity to physical contaminants, even after participants washed their hands. ERP for CC was associated with unique changes in CC and MC across self-report and behavioral measures, and greater pretreatment MC predicted greater posttreatment CC, though this effect was evident in only one of two CC measures. Additionally, specificity analyses indicated changes in MC were independent of changes in disgust propensity, a related construct. Pretreatment disgust propensity also predicted treatment outcome, though the addition of pretreatment disgust propensity as a covariate reduced the relationship between pretreatment MC and posttreatment CC to nonsignificance. Results suggest MC plays an important role in the manifestation and treatment of CC symptoms and may represent a manifestation of disgust proneness. Theoretical and clinical implications are discussed.

O prazer e a dor na adicção sexual: vicissitudes do masoquismo / Plaisir et douleur dans l'adiction sexuelle: les vicissitudes du masochisme / El placer y el dolor en la adicción sexual: las vicisitudes del masoquismo / Pleasure and pain in sexual addiction: vicissitudes of masochism

Resumo A adicção sexual pode ser definida como quadro psicopatológico no qual o sexo é buscado de forma incontrolável, desenfreada, a despeito dos prejuízos emocionais, sociais e profissionais que suscita no cotidiano do adicto. Após o frenesi, a excitação e a adrenalina em ceder aos próprios impulsos urgentes e vorazes, o sex-addict percebe-se incapaz de gerenciar suas atuações sexuais, sendo consumido por sentimentos de vazio, fracasso e desespero. A problemática do prazer sexual "além do princípio de prazer", conjugada à da dor psíquica, nos conduz a uma interrogação mais rigorosa sobre a dimensão do masoquismo na vida subjetiva e sua relação com os estados destrutivos da psicossexualidade. Neste artigo, fundamentado sob o viés da psicanálise, procuramos examinar a estreita relação entre autodestruição e satisfação libidinal nos fenômenos próprios do quadro em questão.

Résumé La dépendance sexuelle peut être définie comme une condition psychopathologique dans laquelle le sexe est cherché de façon incontrôlable, effrénée, malgré les préjudices émotionnels, sociaux et professionnels causés à la vie quotidienne de le dépendent. Après la frénésie, l'excitation et l'adrénaline ressenties en s'adonnant à ses propres impulsions urgentes et voraces, le sex-addict se sent incapable de gérer ses performances sexuelles, consumés par des sentiments de vide, d'échec et de désespoir. Le problème du plaisir sexuel « au-delà du principe du plaisir ¼, combiné à celui de la douleur psychique, conduit à un questionnement plus rigoureux sur la dimension du masochisme dans la vie subjective et sa relation avec les états destructeurs de la psychosexualité. Dans cet article, basé sur la perspective de la psychanalyse, on cherche à examiner la relation étroite entre l'autodestruction et la satisfaction libidinale dans les phénomènes caractéristiques de la condition en question.

Resumen La adicción sexual puede ser definida como un cuadro psicopatológico en el cual se busca el sexo de forma incontrolable, desenfrenada, a pesar de los perjuicios emocionales, sociales y profesionales provocados en el cotidiano del adicto. Después del frenesí, de la excitación y de la adrenalina en ceder a los impulsos urgentes y voraces, el adicto sexual se percibe incapaz de gestionar sus actuaciones sexuales, siendo consumido por sentimientos de vacío, fracaso y desesperación. La problemática del placer sexual "más allá del principio de placer", combinada a la del dolor psíquico, nos conduce a una interrogación más rigurosa sobre la dimensión del masoquismo en la vida subjetiva y su relación con los estados destructivos de la psicosexualidad. Fundamentado en el sesgo del psicoanálisis, en este artículo nos proponemos analizar la estrecha relación entre la autodestrucción y la satisfacción libidinal en los fenómenos propios del cuadro en cuestión.

Abstract Sexual addiction can be defined as a psychopathological condition in which sex is sought in an uncontrollable, unrestrained manner, despite the emotional, social, and professional harm caused to the addict's daily life. After the frenzy, excitement, and adrenaline rush experienced in indulging in their own urgent and eager impulses, sexual addicts find themselves incapable to manage their sexual performances, being consumed by feelings of emptiness, failure, and despair. The issue of sexual pleasure "beyond the pleasure principle," combined with the issue of psychic pain, leads us to a more rigorous questioning about the dimension of masochism in subjective life and its relation with the destructive states of psychosexuality. In this article, based on the perspective of psychoanalysis, we seek to examine the close relation between self-destruction and libidinal satisfaction in the phenomena that are characteristic of the condition in question.

Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil

Objective: There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls. Methods: We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors. Results: Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%). Conclusion: The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.

Women with compulsive buying or gambling disorder: Similar profiles for different behavioural addictions.

The aim of the present study was to examine the differences in sociodemographic and clinical characteristics of 104 women diagnosed with compulsive buying behaviour (CBB = 55) or gambling disorder (GD = 49) treated at three public hospitals unit specialized in behavioural addictions from January 2004 to December 2015. Significant between-group differences in sociodemographic variables were observed for cohabitation status (living with a partner or not) and educational level, with a higher percentage of women in the GD group cohabiting (х2 (1), p = .029). By contrast, the CBB group had a significantly higher educational level (х2 (1) = 7.4, p = .007). There were no significant differences between the groups in age of onset, age at treatment initiation, age at the onset of behavioural problems, or in the years elapsed until presenting addiction problems. However, there were significant between-group differences in the amount of money spent weekly (F (1.100) = 4.9, p = .028), with women in the CBB group spending on average €289.4/week (SD, 412.4) versus €151/week (SD, 141.23) in the GD group. The CBB group had significantly more depressive disorders compared to the GD group (х2(1) = 5.4, p = .020). In contrast, the GD group presented significantly more tobacco use than the CBB group (х2(1) = 1.19, p = .000). This study suggests that women with CBB or GD share more characteristics than differences and the treatment approaches must take into account gender related factors.

Impulse control disorders in Parkinson's disease: Review of pathophysiology, epidemiology, clinical features, management, and future challenges.

Impulsive-compulsive behavior (ICB) in Parkinson's disease (PD) suggests a combination of impulse control disorders (ICDs), such as pathological gambling, hypersexuality, compulsive eating, excessive buying, and compulsive behaviors, such as punding, dopamine dysregulation syndrome (DDS), hoarding, and hobbyism. Hypersexuality and gambling are common in male patients while compulsive buying is common in women patients. Recent studies reveal the prevalence of ICB to be more than 25% among the PD patients. The nigrostriatal, mesocortical, and mesolimbic dopaminergic pathways play a crucial role in the pathogenesis of ICDs in PD patients. The greater tonic release of dopamine creates a state of relative dopamine deficit and reduced reward sensation and impulsive behaviors. The major risk factors for ICB are the use of dopamine agonist (DA), male gender, young patient, depression, smoking, drug abuse, Parkin mutation, and family history of ICDs. Single nucleotide polymorphism in dopamine receptors D1, D2, and D3 also acts as a major risk factor. Questionnaire for impulsive-compulsive disorders in PD is the most widely adopted screening tool for the detection of ICB in PD. The major treatment for PD is to discontinue DAs and use prolonged release formulation of the DAs. The role of deep brain stimulation (DBS) and apomorphine in the treatment of ICB is still uncertain. Though DBS can reduce the risk of DDS, it can precipitate new ICBs such as hypersexuality.

Greater mindful eating practice is associated with better reversal learning.

Mindfulness-based interventions are thought to reduce compulsive behavior such as overeating by promoting behavioral flexibility. Here the main aim was to provide support for mindfulness-mediated improvements in reversal learning, a direct measure of behavioral flexibility. We investigated whether an 8-week mindful eating intervention improved outcome-based reversal learning relative to an educational cooking (i.e., active control) intervention in a non-clinical population. Sixty-five healthy participants with a wide BMI range (19-35 kg/m2), who were motivated to change their eating habits, performed a deterministic reversal learning task that enabled the investigation of reward- and punishment-based reversal learning at baseline and following the intervention. No group differences in reversal learning were observed. However, time invested in the mindful eating, but not the educational cooking intervention correlated positively with changes in reversal learning, in a manner independent of outcome valence. These findings suggest that greater amount of mindfulness practice can lead to increased behavioral flexibility, which, in turn, might help overcome compulsive eating in clinical populations.

Compulsive-Like Sufentanil Vapor Self-Administration in Rats.

Opioid misuse is at historically high levels in the United States, with inhalation (ie, smoking and vaping) being one of the most common routes of consumption. We developed and validated a novel preclinical model of opioid self-administration by inhalation that does not require surgery and reliably produces somatic and motivational signs of dependence. Rats were trained to perform an operant response (nosepoke) to receive 10 s of vaporized sufentanil, a potent opioid, in 2 h daily sessions. Rats readily and concentration-dependently self-administered vaporized sufentanil. Rats exhibited a significant increase in responding for sufentanil when given the preferential µ-opioid receptor inverse agonist naloxone, suggesting the participation of µ-opioid receptors in the reinforcing properties of sufentanil vapor. Serum sufentanil concentrations significantly correlated with the number of sufentanil vapor deliveries. Rats that were given long access (LgA; 12 h/day) but not short access (ShA; 1 h/day) to vaporized sufentanil escalated their drug intake over time and exhibited both naloxone-precipitated somatic signs of opioid withdrawal and spontaneous withdrawal-induced mechanical hypersensitivity. After 6 months of forced drug abstinence, LgA rats returned to pre-escalation baseline levels of responding for sufentanil and mechanical sensitivity. Upon subsequent re-escalation (ie, after the return to extended access to sufentanil vapor), LgA rats again developed naloxone-precipitated somatic signs of withdrawal and spontaneous withdrawal-induced mechanical hypersensitivity. These findings demonstrate that the operant sufentanil vapor self-administration model has both face and construct validity and therefore will be useful for investigating the neurobiological basis of opioid addiction.

Perceived intentional transmission of HIV infection, sustained viral suppression and psychosocial outcomes among men who have sex with men living with HIV: a cross-sectional assessment.

OBJECTIVE: HIV continues to be a global and national public health challenge, and men who have sex with men (MSM) are disproportionately affected in the USA. Transmission of HIV is intentional if the person living with HIV knows about his/her serostatus, acts with the intention to and actually transmits HIV. Research on intentional transmission of HIV infections is lacking, and the relationships between perceived intentional transmission, viral suppression and psychosocial outcomes have not been assessed. The objective of this study was to investigate the association between perceived intentional transmission of HIV, sustained viral suppression and psychosocial outcomes. METHODS: Data were obtained from 338 MSM living with HIV who participated in a disclosure intervention study. Logistic and linear regression models were used to assess the associations between perceived intentional transmission and viral suppression, condomless anal intercourse in the past 30 days, being at risk for clinical depression, substance use, self-efficacies for condom use, HIV disclosure and negotiation of safer sex practices, and sexual compulsivity. RESULTS: 44% of the study population reported perceiving intentional HIV transmission. After adjusting for sociodemographic characteristics, men who thought that they were infected intentionally had 69% higher odds (adjusted OR: 1.69; 95% CI 1.01 to 2.83) of being at risk for clinical depression, and on average, scored approximately 3 points and 4 points higher on depressive symptoms and sexual compulsivity, respectively (adjusted ß: 3.29; 95% CI 0.42 to 6.15; adjusted ß: 3.74; 95% CI 1.32 to 6.17) compared with men who did not think that they were intentionally infected. After adjusting for confounders, there was no statistically significant association between perceived intentional transmission and viral suppression. CONCLUSIONS: Intervention programmes for MSM living with HIV who thought they were infected intentionally are warranted and should aim to attenuate depressive symptoms and sexual compulsivity.

Pathological Overeating: Emerging Evidence for a Compulsivity Construct.

Compulsive eating behavior is a transdiagnostic construct that is characteristic of medical and psychiatric conditions such as forms of obesity and eating disorders. Although feeding research is moving toward a better understanding of the proposed addictive properties of food, the components and the mechanisms contributing to compulsive eating are not yet clearly defined or understood. Current understanding highlights three elements of compulsive behavior as it applies to pathological overeating: (1) habitual overeating; (2) overeating to relieve a negative emotional state; and (3) overeating despite aversive consequences. These elements emerge through mechanisms involving pathological habit formation through an aberrant learning process, the emergence of a negative emotional state, and dysfunctions in behavioral control. Dysfunctions in systems within neurocircuitries that comprise the basal ganglia, the extended amygdala, and the prefrontal cortex result in compulsive eating behaviors. Here, we present evidence to relate compulsive eating behavior and addiction and to characterize their underlying neurobiological mechanisms. A major need to improve understanding of compulsive eating through the integration of complex motivational, emotional, and cognitive constructs is warranted.

Psychiatric and socioeconomic aspects as possible predictors of compulsive buying behavior / Aspectos psiquiátricos e socioeconômicos como possíveis preditores de comportamento de compras compulsivas

Abstract Introduction: Compulsive buying can be characterized as an almost irresistible urge to buy various items. Compulsive buying disorder is a subject of growing interest to health professionals. It is a current issue and the prevalence rate in the global population is around 5 to 8%. Objectives: The main objective of this study was to identify predictors of compulsive buying in the Brazilian population, assessing possible relationships between compulsive buying, depression and anxiety. Methods: The Richmond Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 359 participants. Pearson coefficients were used to test for correlations. Results: Our study identified an interaction between female gender and compulsion to purchase. Furthermore, people's occupations also appear to have an influence on the problem. We found a correlation between depressive symptoms and oniomania. Conclusion: Our study has certain limitations, such as the difficulty in recruiting individuals with compulsive buying disorder. Since compulsive buying is a phenomenon that is seldom investigated, it therefore remains unidentified. However, this is nevertheless a pioneering paper on the Brazilian population.

Resumo Introdução: A compra compulsiva pode ser caracterizada como um desejo quase irresistível de obter vários itens. O transtorno do comprar compulsivo tem sido objeto de interesse crescente para os profissionais de saúde. Considerado um problema atual, sua taxa de prevalência é de cerca de 5 a 8% na população mundial. Objetivos: O principal objetivo desta pesquisa foi identificar os preditores da compulsão por comprar na população brasileira, avaliando possíveis relações entre compra compulsiva, depressão e ansiedade. Métodos: A Escala de Compras Compulsivas Richmond Adaptada foi utilizada para rastreio do comprar compulsivo, e a Escala Hospitalar de Ansiedade e Depressão, para avaliar ansiedade e depressão, em uma amostra de 359 participantes. As correlações foram determinadas usando o teste de Pearson. Resultados: Foi identificada em nosso estudo uma interação entre sexo feminino e compulsão por compras. Além disso, a ocupação parece interferir no problema. Encontramos uma correlação entre sintomas depressivos e oniomania. Conclusão: Nosso estudo apresenta algumas limitações, tais como a dificuldade em recrutar indivíduos com transtorno do comprar compulsivo. Por ser um tema pouco explorado, há uma dificuldade em identificar indivíduos acometidos. No entanto, este é um ensaio pioneiro na população brasileira.