Unit 12 Impulsivity and Compulsivity. 800w due 11-24-23. 4 references

Peer Response

Instructions:

Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Ingrid

Please describe the role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors. 

Describing the mesolimbic dopamine pathway in my own words could be a bit difficult and confusing. Please correct me if I am wrong, but the way I understood this was that the mesolimbic dopamine pathway is the path responsible for reinforcement and reward in the brain that has to do with anything found “pleasurable” (Stahl et al., 2021). The path or road would start in the nucleus accumbens then travel to the VTA while releasing dopamine-and we all know that dopamine is the “feel-good hormone”  (Dopamine: What it is, Function & Symptoms, 2023). Our book even mentions this pathway works with simple activities such as listening to music since the brain develops a sort of addiction to that good feeling-(releasing dopamine).

Please provide two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. Our book shows how the mesolimbic pathway/dopamine releases with natural “high” behaviors like winning a race (pg, 542) but there are other types of highs such as behaviorally induced highs and substance-induce highs (Stahl et al., 2021). The problem is when the latest two highs become addictive, and addiction can be a huge problem, and more like a disease (Stahl et al., 2021). We can focus more on substance abuse addictions and the way we can eliminate the compulsive and impulsive behavior related to it. It seems every substance has its own treatment, but abstinence would be the ultimate goal (Stahl et al., 2021). Unfortunately, abstinence is not achieved overnight, and in some cases is very hard to maintain. Our book mentions that giving the patient psychopharmacological agents that imitate the substance can prevent that patient from seeking abuse of the mentioned drug (Stahl et al., 2021). It prevents the impulse of seeking. Other modes of treatment for other addictions can be therapies and medications intended to control impulsivity and compulsivity (Stahl et al., 2021)

References:

Professional, C. C. Medical. (2023). 
Dopamine: What it is, Function & Symptoms. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22581-dopamine

Stahl, S. M., Muntner, N., & Grady, M. M. (2021). 
Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press.

Mojgan

Week 12, Impulsivity and Compulsivity

Please describe the role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors.

        To address this question, we must first grasp the definitions of impulsivity and compulsivity. According to Stahl (2021), impulsivity involves rapid, unplanned reactions to various triggers such as a child who acts without thinking about the consequences. In mental health, examples of impulsive behaviors include ADHD, reckless spending during mania, Autism, and Tourette syndrome. On the flip side, compulsivity refers to the inability to cease dysfunctional behaviors despite knowing that they have negative consequences. Individuals with OCD may recognize that their hands are clean but struggles to stop repeatedly washing them. Similarly, individuals struggling with addiction may be aware that the drug is harming their lives but continue to persistently misuse it.

         In both behaviors, the brain has lost control over actions, in impulsivity, the brain cannot control and stop initiating actions, and in compulsivity, the brain cannot discontinue and finish ongoing actions. According to Stahl (2021), a simplified and straightforward explanation for why patients are unable to cease impulsivity and compulsivity is: “too much bottom-up limbic emotional drive or too little top-down cortical inhibition of these drives” (p. 539).

        Our brain has the ability to naturally generate pleasurable neurotransmitters. The brain is capable of producing its own versions of morphine/heroin (endorphins), marijuana (anandamide), nicotine (acetylcholine), cocaine, and amphetamine (dopamine itself). These internal substances play a role in regulating the mesolimbic dopamine pathway. Engaging in activities like sex, drinking, and eating can influence this pathway, leading to the production of more internal pleasurable substances and resulting in natural highs. Importantly, the brain cannot distinguish between internal (natural pleasurable substances) and external (artificial pleasurable substances). Dysregulation of the mesolimbic dopamine pathway (reward network) will lead to clinical manifestations of impulsive and compulsive behaviors (Stahl, 2021).

        Therefore, psychotropic drugs can imitate the effects of the brain’s internal and natural pleasurable substances. They work by bypassing the brain’s own neurotransmitters and directly stimulating the brain’s receptors in the reward system, leading to the release of dopamine and an artificial high. Consequently, substances such as alcohol, opioids, stimulants, marijuana, benzodiazepines, sedative-hypnotics, hallucinogens, and nicotine have the ability to activate this mesolimbic dopaminergic system, providing pleasure and enjoyment for consumers. Unfortunately, individuals can experience a more potent incentive and pleasure in the short run from drugs than what they can derive from a natural high with the brain’s natural neurotransmitters (Stahl, 2021).

Please provide two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. 

         One of the interventions to reduce or eliminate compulsive/impulsive behaviors in alcohol and other drug use disorders is Cognitive Behavioral Therapy (CBT). According to Magill et al. (2023), CBT is one of the most researched and studied addiction treatments globally. 94 percent of treatment facilities in the U.S use CBT to address addiction-related behaviors (impulsivity/compulsivity). CBT is defined as a course of interventions that are limited in time, target specific concerns, and rely on two crucial bases: cognitive, which identifies how our thoughts affect our feelings and actions, and behavioral, which identifies how our actions shape emotions and thoughts (Magill et al., 2023).

        The second intervention that can decrease or eliminate compulsive/impulsive behavior in addicted individuals is pharmacotherapy. Recent studies have shown a growing interest in ‘precision medicine’ or ‘personalized medicine’. According to the literature, the ‘one-size-fits-all’ approach is no longer effective, and there is a need to tailor treatment efficiently based on an individual’s conditions, characteristics, and needs (Magill et al., 2023). A research study found that the readiness of patients with addiction to participate in a specific therapy was influenced by their expectations of experiencing withdrawal symptoms, both at the beginning and end of treatment, and how severe they expected these symptoms to be (Meenu et al., 2022).

References

Magill, M., Kiluk, B. D., & LA, R. (2023). Efficacy of cognitive behavioral therapy for alcohol and other drug use disorders: Is a one-size-fits-all approach appropriate?
 Substance Abuse and Rehabilitation, 14, 1-11. 
https://doi.org/10.2147/SAR.S362864Links to an external site.

Meenu, M., Cooper, A., Sousa, S., Costello, M. J., & MacKillop, J. (2022). Characterizing clinical heterogeneity in a large inpatient addiction treatment sample: Confirmatory latent profile analysis and differential levels of craving and impulsivity.
 Substance Abuse: Research and Treatment, 16 https://doi.org/10.1177/11782218221126977

Stahl, S. M. (2021). 
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).