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Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals.
Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association APA has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the revision of their Diagnostic and Statistical Manual.
Other Internet related behaviors, e. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model.
The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction.
Future research needs to address whether or not there are specific differences between substance and behavioral addiction. Introduction A revolutionary paradigm shift is occurring in the field of addiction that has great implications for assessment and treatment. It is now evident that various behaviors, which are repeatedly reinforcing the reward, motivation and memory circuitry are all part of the disease of addiction [ 2345678910 ].
Common mechanisms among addiction involving various psychoactive substances such as alcohol, opioids and cocaine; and pathological behaviors such as uncontrolled gambling, internet use, gaming, pornography and sexual acting out have also been delineated.
As a result of the growing neuroscientific evidence, the American Society of Addiction Medicine ASAM formally expanded their definition of addiction in to include both behaviors and substances: Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.
Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. The gaming prompts a neurological response that influences feelings of pleasure and reward, and the result, in the extreme, is manifested as addictive behavior.
Excessive use of the Internet not involving playing of online games e. This also matches Griffiths proposed differentiation between addictions to the Internet and addictions on the Internet [ 16 ]. An easier and perhaps more functional decision, however, would have been to maintain the proposed diagnosis of IA but simply require a subtype or specifier; gaming, pornography, social networking, shopping, etc.
Indeed, the original formal proposal for IA to be included in the DSM-5 incorporated the subtypes of instant messaging, pornography use, and video games [ 17 ], expanded later to include social networking [ 18 ].
This would have aligned the DSM-5 with what has, in fact, occurred in the field since its publication, namely, the continued scientific investigation into the broad range of potentially problematic behaviors involving Internet use.
This inclusive approach has been proposed multiple times, both historically [ 17 ] and recently [ 1920 ]. Conceptualizing IA as a generalized problem with more specific subtypes is ripe for formal reconsideration.
There is a key element found throughout all internet-related experiences: The ability to maintain or heighten arousal with the click of a mouse or swipe of a finger.
Thus, the act of seeking which would include surfing triggers the reward system [ 22 ]. Some internet activities, because of their power to deliver unending stimulation and activation of the reward systemare thought to constitute supernormal stimuli [ 24 ], which helps to explain why users whose brains manifest addiction-related changes get caught in their pathological pursuit.
To illustrate this phenomenon, Tinbergen created artificial bird eggs that were larger and more colorful than actual bird eggs. Surprisingly, the mother birds chose to sit on the more vibrant artificial eggs and abandon their own naturally laid eggs. Similarly, Tinbergen created artificial butterflies with larger and more colorful wings, and male butterflies repeatedly tried to mate with these artificial butterflies in lieu of actual female butterflies.
Evolutionary Psychologist Dierdre Barrett took up this concept in her recent book Supernormal Stimuli: We humans can produce our own. In short, generalized internet chronic overuse is highly stimulating. It recruits our natural reward system, but potentially activates it at higher levels than the levels of activation our ancestors typically encountered as our brains evolved, making it liable to switch into an addictive mode [ 27 ].
In the review that follows we will first provide an overview of the major theoretical understanding or models of addiction involving substances and of the neuroscientific basis on which the addictive processes work, whether there is involvement with substances or behaviors.
We will then review the existing neuroscientific studies relating to the behavioral aspects of addiction generally, then the more specific problem of Gambling Disorder, and then progress to the flood of recent studies on IA, and its subtypes of gaming and pornography.
The majority of studies discussed examined key aspects of addiction involving behaviors through laboratory investigation, including functional neuroimaging studies and structural and resting-state neuroimaging studies.
These bear on the established science relating to addiction generally.
Where relevant, we have also discussed neuropsychological studies, which suggest laboratory behavioral parallels with brain studies such as those on structural brain abnormalities thought to be the result of addiction. We have chosen to narrow our focus primarily to the neuroscientific research findings relating to addiction involving behaviors, despite the fact that there is also a large and growing body of research relating to their clinical presentation, epidemiology, health effects, public health ramifications, etc.1.
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Author Contributions. Todd Love conceived the project, conducted the literature review, and wrote the main part paper. Christian Laier and Matthias Brand contributed theoretically to the manuscript, wrote parts of the manuscript, and revised the manuscript.
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