Sex addiction and gambling disorder: similarities and differences.

OBJECTIVE: Recently, the DSM-5 has developed a new diagnostic category named "Substance-related and Addictive Disorders". This category includes gambling disorder (GD) as the sole behavioral addiction, but does not include sex addiction (SA). The aim of this study is to investigate whether SA should be classified more closely to other behavioral addictions, via a comparison of the personality characteristics and comorbid psychopathology of individuals with SA with those of individuals with GD, which comes under the category of addiction and related disorders. METHOD: The sample included 59 patients diagnosed with SA, who were compared to 2190 individuals diagnosed with GD and to 93 healthy controls. Assessment measures included the Diagnostic Questionnaire for Pathological Gambling, the South Oaks Gambling Screen, the Symptom CheckList-90 Items-Revised and the Temperament and Character Inventory-Revised. RESULTS: No statistically significant differences were found between the two clinical groups, except for socio-economic status. Although statistically significant differences were found between both clinical groups and controls for all scales on the SCL-90, no differences were found between the two clinical groups. The results were different for personality characteristics: logistic regression models showed that sex addictive behavior was predicted by a higher education level and by lower scores for TCI-R novelty-seeking, harm avoidance, persistence and self-transcendence. Being employed and lower scores in cooperativeness also tended to predict the presence of sex addiction. CONCLUSIONS: While SA and GD share some psychopathological and personality traits that are not present in healthy controls, there are also some diagnostic-specific characteristics that differentiate between the two clinical groups. These findings may help to increase our knowledge of phenotypes existing in behavioral addictions.

Cognitive behavioral therapy for compulsive buying behavior: Predictors of treatment outcome.

BACKGROUND: Compulsive buying behavior (CBB) is receiving increasing consideration in both consumer and psychiatric-epidemiological research, yet empirical evidence on treatment interventions is scarce and mostly from small homogeneous clinical samples. OBJECTIVES: To estimate the short-term effectiveness of a standardized, individual cognitive behavioral therapy intervention (CBT) in a sample of n=97 treatment-seeking patients diagnosed with CBB, and to identify the most relevant predictors of therapy outcome. METHOD: The intervention consisted of 12 individual CBT weekly sessions, lasting approximately 45minutes each. Data on patients' personality traits, psychopathology, sociodemographic factors, and compulsive buying behavior were used in our analysis. RESULTS: The risk (cumulative incidence) of poor adherence to the CBT program was 27.8%. The presence of relapses during the CBT program was 47.4% and the dropout rate was 46.4%. Significant predictors of poor therapy adherence were being male, high levels of depression and obsessive-compulsive symptoms, low anxiety levels, high persistence, high harm avoidance and low self-transcendence. CONCLUSION: Cognitive behavioral models show promise in treating CBB, however future interventions for CBB should be designed via a multidimensional approach in which patients' sex, comorbid symptom levels and the personality-trait profiles play a central role.

Modulation of Irisin and Physical Activity on Executive Functions in Obesity and Morbid obesity.

Whether the executive profile is different between obesity (OB) and morbid obesity (MO) remains unclear. Recent evidence suggests that physical activity (PA) can act as a cognitive enhancer. Irisin is a recently discovered hormone associated with some of the positive effects of PA. The objective of the study was to investigate the executive profile in OB and MO, and to explore the role of PA and irisin. 114 participants were included (21 OB, 44 MO and 49 healthy controls-HC) in the study and assessed with the Wisconsin Card Sorting Test, Stroop Color and Word Test, and Iowa Gambling Task. All participants were female, aged between 18 and 60 years. Results showed a similar dysfunctional profile on decision making in OB and MO compared with HC. Thus, no specific neuropsychological profiles between OB and MO can be clearly observed in our sample. However, a negative correlation was found between irisin and executive functioning. These results demonstrate a specific executive profile in OB and a relevant and negative modulation of irisin on executive functioning. Although irisin might be a promising target for the treatment of obesity, its effects on cognition might be considered when thinking about its therapeutic use.

Emotion processing in joint hypermobility: A potential link to the neural bases of anxiety and related somatic symptoms in collagen anomalies.

BACKGROUND: Joint hypermobility syndrome (JHS) has repeatedly been associated with anxiety and anxiety disorders, fibromyalgia, irritable bowel syndrome and temporomandibular joint disorder. However, the neural underpinnings of these associations still remain unclear. This study explored brain responses to facial visual stimuli with emotional cues using fMRI techniques in general population with different ranges of hypermobility. METHODS: Fifty-one non-clinical volunteers (33 women) completed state and trait anxiety questionnaire measures, were assessed with a clinical examination for hypermobility (Beighton system) and performed an emotional face processing paradigm during functional neuroimaging. RESULTS: Trait anxiety scores did significantly correlate with both state anxiety and hypermobility scores. BOLD signals of the hippocampus did positively correlate with hypermobility scores for the crying faces versus neutral faces contrast in ROI analyses. No results were found for any of the other studied ROIs. Additionally, hypermobility scores were also associated with other key affective processing areas (i.e. the middle and anterior cingulate gyrus, fusiform gyrus, parahippocampal region, orbitofrontal cortex and cerebellum) in the whole brain analysis. CONCLUSIONS: Hypermobility scores are associated with trait anxiety and higher brain responses to emotional faces in emotion processing brain areas (including hippocampus) described to be linked to anxiety and somatic symptoms. These findings increase our understanding of emotion processing in people bearing this heritable variant of collagen and the mechanisms through which vulnerability to anxiety and somatic symptoms arises in this population.

Neuroanatomía del trastorno por déficit de atención/hiperactividad en el adulto: hallazgos de neuroimagen estructural y funcional / The neuroanatomy of attention deficit hyperactivity disorder in adults: structural and functional

Este trabajo tiene como objetivo revisar la bibliografía existente sobre los hallazgos de resonancia magnética estructural, funcional y conectividad. Durante mucho tiempo, se ha pensado que los niños superaban el trastorno por déficit de atención/hiperactividad (TDAH) al llegar a la adolescencia. Sin embargo, actualmente se sabe que hasta un 70% de los niños que presentaban TDAH en la infancia continúa presentando síntomas en la esfera conductual y cognitiva en la edad adulta. Estudios de neuroimagen realizados en adultos con TDAH han mostrado alteraciones cerebrales a nivel estructural, funcional y en conectividad. Estos hallazgos se han observado principalmente en el córtex frontal inferior y prefrontal dorsolateral, así como en regiones estriatales, del cíngulo anterior, parietotemporales y cerebelares. Sin embargo, se han encontrado algunas inconsistencias, posiblemente relacionadas con la presencia de comorbilidad, historia de medicación, diferencias por género y el reducido tamaño de la muestra utilizada en algunos estudios. También se han observado diferencias en relación con los estudios realizados en niños con TDAH. De ahí la importancia para futuros estudios de evitar que existan variables que puedan afectar los hallazgos en el TDAH en adultos y, además, poder comprobar si los déficits anatómicos y funcionales persisten en la edad adulta (AU)

The objective of this work is to review the existing literature on findings from structural and functional magnetic resonance and connectivity. For a long time it was thought that children ‘grew out’ of attention deficit hyperactivity disorder (ADHD) on reaching adolescence. Yet, it is now known that up to 70% of children who present ADHD in childhood go on to present symptoms in the behavioural and cognitive sphere in adulthood. Neuroimaging studies conducted in adults with ADHD have shown alterations in the brain at the structural and functional levels, and also in terms of connectivity. These findings have been observed mainly in the inferior frontal and dorsolateral prefrontal cortex, as well as in striatal, anterior cingulate, parietotemporal and cerebellar regions. However, certain inconsistencies have also been found, which may be related with the presence of comorbidity, a history of medication, gender-related differences and the small size of the sample used in some studies. Differences have also been noted in relation to studies carried out in children with ADHD. Hence the importance for future studies of avoiding the existence of variables that can affect the findings in ADHD in adults and, moreover, of being able to determine whether the anatomical and functional déficits continue into adulthood (AU)