The Reward Deficiency Syndrome

Heavy Drinking informs the general public for the first time how recent research has discredited almost every widely held belief about alcoholism, including the very concept of alcoholism as a single disease with a unique cause. Herbert Fingarette presents constructive approaches to heavy drinking, including new methods of helping heavy drinkers and social policies for preventing heavy drinking and the harms associated with it.

Addiction focuses on the emergence, nature, and persistence of addictive behavior, as well as the efforts of addicts to overcome their condition. Do addicts act of their own free will, or are they driven by forces beyond their control? Do structured treatment programs offer more hope for recovery? What causes relapses to occur? Recent scholarship has focused attention on the voluntary aspects of addiction, particularly the role played by choice. Addiction draws upon this new research and the investigations of economists, psychiatrists, philosophers, neuropharmacologists, historians, and sociologists to offer an important new approach to our understanding of addictive behavior. The notion that addicts favor present rewards over future gains or penalties echoes throughout the chapters in Addiction. The effect of cultural values and beliefs on addicts, and on those who treat them, is also explored, particularly in chapters by Elster on alcoholism and by Acker on American heroin addicts in the 1920s and 1930s. Essays by Gardner and by Waal and Mørland discuss the neurobiological roots of addiction Among their findings are evidence that addictive drugs also have an important effect on areas of the central nervous system unrelated to euphoria or dysphoria, and that tolerance and withdrawal phenomena vary greatly from drug to drug. The plight of addicts struggling to regain control of their lives receives important consideration in Addiction. Elster, Skog, and O'Donoghue and Rabin look at self-administered therapies ranging from behavioral modifications to cognitive techniques, and discuss conditions under which various treatment strategies work. Drug-based forms of treatment are discussed by Gardner, drawing on work that suggests that parts of the population have low levels of dopamine, inducing a tendency toward sensation-seeking. There are many different explanations for the impulsive, self-destructive behavior that is addiction. By bringing the triple perspective of neurobiology, choice, and culture to bear on the phenomenon, Addiction offers a unique and valuable source of information and debate on a problem of world-wide proportions.

The intention of this book was to have investigators describe an expert opinion on their field of research and cutting-edge work in their laboratory on the neurobiology and treatment of eating disorders.

Humans are biologically programmed to seek out pleasurable experiences. These experiences are processed in the mesolimbic system, also referred to as the "reward center" of the brain, where a number of chemical messengers work in concert to provide a net release of dopamine in the Nucleus Accumbens. In some genetically predisposed individuals, addiction occurs when the mechanisms of the mesolimbic system are disrupted by the use of various drugs of abuse. Since Alcoholics Anonymous was founded in 1935, it's 12 step program of spiritual and character development has helped countless alcoholics and drug addicts curb their self-destructive behaviors. However, the program was developed at a time when comparatively little was known about the function of the brain and it has never been studied scientifically. This is the first book to take a systematic look at the molecular neurobiology associated with each of the 12 steps and to review the significant body of addiction research literature that is pertinent to the program.​

The interest in ‘biomarkers’ seen across a spectrum of biomedical disciplines reflects the rise of molecular biology and genetics. A host of ‘omics’ disciplines in addition to genomics, marked by multidimensional data and complex analyses, and enabled by bioinformatics, have pushed the trajectory of biomarker development even further. They have also made more tractable the complex mappings of genotypes to phenotypes – genome-to-phenome mapping – to which the concept of a biomarker is central. Genomic investigations of the brain are beginning to reveal spectacular associations between genes and neural systems. Neural and cognitive phenomics are considered a necessary complement to genomics of the brain. Other major omics developments such as connectomics, the comprehensive mapping of neurons and neural networks, are heralding brain maps of unprecedented detail. Such developments are defining a new era of brain science. And in this new research environment, neural systems and cognitive operations are pressed for new kinds of definitions – that facilitate brain-behavioral alignment in an omics operating environment. This volume explores the topic of markers framed around the constructs of cognitive and neural systems. ‘Neurophenotype’ is a term adopted to describe a neural or cognitive marker that can be scientifically described within an associative framework – and while the genome-to-phenome framework is the most recognized of these, epigenetics and non-gene-regulated neural dynamics also suggest other frameworks. In either case, the term neurophenotype defines operational constructs of brain-behavioral domains that serve the integration of these domains with neuroscientific and omics models of the brain. The topic is critically important to psychiatry and neuropsychology: Neurophenotypes offer a ‘format’ and a ‘language’ by which psychiatry and neuropsychology can be in step with the brain sciences. They also bring a new challenge to the clinical neurosciences in terms of construct validation and refinement. Topics covered in the volume include: Brain and cognition in the omics era Phenomics, connectomics, and Research Domain Criteria Circuit-based neurophenotypes, and complications posed by non-gene regulated factors The legacy of the endophenotype concept – its utility and limitations Various potential neurophenotypes of relevance to clinical neuroscience, including Response Inhibition, Fear Conditioning and Extinction, Error Processing, Reward Dependence and Reward Deficiency, Face Perception, and Language Phenotypes Dynamic (electrophysiological) and computational neurophenotypes The challenge of a cultural shift for psychiatry and neuropsychology The volume may be especially relevant to researchers and clinical practitioners in psychiatry and neuropsychology and to cognitive neuroscientists interested in the intersection of neuroscience with genomics, phenomics and other omics disciplines.