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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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In Europe, the rate of problem gambling is typically 0.5 to 3 percent. The "British Gambling Prevalence Survey 2007", conducted by the United Kingdom Gambling Commission, found approximately 0.6 percent of the adult population had problem gambling issues—the same percentage as in 1999. The highest prevalence of problem gambling was found among those who participated in spread betting (14.7%), fixed odds betting terminals (11.2%) and betting exchanges (9.8%). In Norway, a December 2007 study showed the amount of present problem gamblers was 0.7 percent.
A gambler who does not receive treatment for pathological gambling when in his or her desperation phase may contemplate suicide. Problem gambling is often associated with increased suicidal ideation and attempts compared to the general population.
Early onset of problem gambling increases the lifetime risk of suicide. However, gambling-related suicide attempts are usually made by older people with problem gambling. Both comorbid substance use and comorbid mental disorders increase the risk of suicide in people with problem gambling. A 2010 Australian hospital study found that 17% of suicidal patients admitted to the Alfred Hospital's emergency department were problem gamblers. In the United States, a report by the National Council on Problem Gambling showed approximately one in five pathological gamblers attempt suicide. The council also said that suicide rates among pathological gamblers were higher than any other addictive disorder.
Most research has focused on adult population or on college students, but little is known about epidemiology of behavioral addictions in adolescence. A study conducted by Villella "et al" looked at a group of students and the prevalence of various addictions. His results showed exercise addiction was the second most prevalent, after compulsive buying.
High risk groups that appear to be addicted to exercise include athletes in sports encouraging thinness or appearance standards, young and middle-age women, and young men.
The consequences of oniomania, which may persist long after a spree, can be devastating, with marriages, long-term relationships, and jobs all feeling the strain. Further problems can include ruined credit history, theft or defalcation of money, defaulted loans, general financial trouble and in some cases bankruptcy or extreme debt, as well as anxiety and a sense of life spiraling out of control. The resulting stress can lead to physical health problems and ruined relationships, or even suicide.
Individuals with exercise addiction may put exercise above family and friends, work, injuries, and other social activities. If not identified and treated, an exercise addiction may lead to a significant decline in one's health.
Complications of late Parkinson's disease may include a range of impulse-control disorders, including eating, buying, compulsive gambling and sexual behavior. One study found that 13.6% of Parkinson's patients exhibited at least one form of ICD. There is a significant co-occurrence of pathological gambling and personality disorder, and is suggested to be caused partly by their common "genetic vulnerability". The degree of heritability to ICD is similar to other psychiatric disorders including substance abuse disorder. There has also been found a genetic factor to the development of ICD just as there is for substance abuse disorder. The risk for subclinical PG in a population is accounted for by the risk of alcohol dependence by about 12-20% genetic and 3-8% environmental factors. There is a high rate of comorbidity between ADHD and other impulse-control disorders.
Diagnostic criteria for compulsive buying have been proposed: 1. Over-preoccupation with buying; 2. distress or impairment as a result of the activity; 3. compulsive buying is not limited to hypomanic or manic episodes.
While initially triggered by a perhaps mild need to feel special, the failure of compulsive shopping to actually meet such needs may lead to a vicious cycle of escalation, with sufferers experiencing the highs and lows associated with other addictions. The 'high' of the purchasing may be followed by a sense of disappointment, and of guilt, precipitating a further cycle of impulse buying. With the now addicted person increasingly feeling negative emotions like anger and stress, they may attempt to self-medicate through further purchases, followed again by regret or depression once they return home - leading to an urge for yet another spree.
As debt grows, the compulsive shopping may become a more secretive act. At the point where bought goods are hidden or destroyed, because the person concerned feels so ashamed of their addiction, the price of the addiction in mental, financial and emotional terms becomes even higher.
Environmental factors that may lead to pyromania include an event that the patient has experienced in the environment they live in. Environmental factors include neglect from parents and physical or sexual abuse in earlier life. Other causes include early experiences of watching adults or teenagers using fire inappropriately and lighting fires as a stress reliever .
The rate of people who have problems of shopping addiction is a very controversial matter, because the dividing line between pathological behaviours and those behaviours which, even if excessive, are socially accepted, is very difficult to determine. However, shopping addiction and other manifestations of the lack of self-control on spending are widespread problems which are constantly expanding. Studies using samples of the general population show that between 8% and 16% of the people have problems with excessive or uncontrolled purchases. Clinical studies give much lower figures, however, between 2% and 5%. According to the European Report on the programme for the prevention and treatment of personal problems related to consumer addiction, personal purchasing habits and over-indebtedness, 3% of European adults and 8% of European young people have a level of shopping addiction which could be considered as pathologic, that is, which seriously affects the life of the people who suffer from this. Other estimates for the prevalence of compulsive buying range from a low of 2 percent to 12 percent or more (in the U.S. population.
Most of people who have these problems neither receive nor ask for treatment. Those that ask for help only do it after years of suffering, when the addiction has caused very serious economic repercussion and has harmed the relationship with their family and social environment. For this reason and due to the lack of social consciousness about this problem, the unrecorded figure of people who suffer from these problems is very high. In addition to the severe cases of shopping addiction, an important part of consumers (between 30% and 50% of the population) have deficiencies with spending self-control or excessive purchases. According to the European Report, 33% of European adults and 46% of the European young people have minor or moderate problems with shopping addiction or lack of economic self-control.
Kleptomania is frequently thought of as being a part of obsessive-compulsive disorder (OCD), since the irresistible and uncontrollable actions are similar to the frequently excessive, unnecessary, and unwanted rituals of OCD. Some individuals with kleptomania demonstrate hoarding symptoms that resemble those with OCD.
Prevalence rates between the two disorders do not demonstrate a strong relationship. Studies examining the comorbidity of OCD in subjects with kleptomania have inconsistent results, with some showing a relatively high co-occurrence (45%-60%) while others demonstrate low rates (0%-6.5%). Similarly, when rates of kleptomania have been examined in subjects with OCD, a relatively low co-occurrence was found (2.2%-5.9%).
Pyromania is best prevented by parents taking the time to educate their children on fire safety and the dangers of fires. Parents should also keep all fire lighting devices out of reach of children and any teenagers to reduce the risk of their starting any fires .
Kleptomania is characterized by an impulsive urge to steal purely for the sake of gratification.
In the U.S. the presence of kleptomania is unknown but has been estimated at 6 per 1000 individuals. Kleptomania is also thought to be the cause of 5% of annual shoplifting in the U.S. If true, 100,000 arrests are made in the U.S. annually due to kleptomaniac behavior.
Specific genes predispose people to drug addiction—it's one of the behavioral disorders most strongly corrolated with genetic makeup—but environmental factors, especially trauma and mistreatment in childhood, also correlate strongly with addiction. . Examples such as physical or sexual abuse, and unpredictable expectations and behavior of parents, increase a person's risk for developing addiction.
Kleptomania and drug addictions seem to have central qualities in common, including:
- recurring or compulsive participation in a behavior in spite of undesirable penalties;
- weakened control over the disturbing behavior;
- a need or desire condition before taking part in the problematic behavior; and
- a positive pleasure-seeking condition throughout the act of the disturbing behavior.
Data from epidemiological studies additionally propose that there is an affiliation between kleptomania and substance use disorders along with high rates in a unidirectional manner. Phenomenological data maintain that there is a relationship between kleptomania and drug addictions. A higher percentage of cases of kleptomania has been noted in adolescents and young adults, and a lesser number of cases among older adults, which imply an analogous natural history to that seen in substance use disorders. Family history data also propose a probable common genetic input to alcohol use and kleptomania. Substance use disorders are more common in kin of persons with kleptomania than in the general population. Furthermore, pharmacological data (e.g., the probable efficacy of the opioid antagonist, naltrexone, in the treatment of both kleptomania and substance use disorders) could present additional support for a joint relationship between kleptomania and substance use disorders. Based on the idea that kleptomania and substance use disorders may share some etiological features, it could be concluded that kleptomania would react optimistically to the same treatments. As a matter of fact, certain nonmedical treatment methods that are successful in treating substance abuse are also accommodating in treating kleptomania.
Another growing area is social media addiction. Psychology researchers surveyed 253 undergraduate students at the University of Albany and found that not only is social media (particularly Facebook) itself potentially addictive, those who use it may also be at greater risk for substance abuse.
Another form of behavior that is still being investigated is obsessive sun tanning as a behavioral addiction. In a recent study, researchers have proved that many frequent tanners demonstrate signs and symptoms adapted from substance abuse or dependence criteria. Many people who admit to being frequent tanners say they tan to look good, feel good, and to relax. People who partake in excessive tanning are usually completely aware of the health risks associated with it, just like addicted smokers are completely aware of the health risks of smoking. The health hazards are even more severe for high-risk age groups such as teenagers and young adults. Due to the fact that the health risks do not deter tanners from their habit, they are exhibiting self-destructive behavior that resembles the characteristics of those who suffer from substance abuse.
Frequent tanners have said a primary reason why they participate in artificial tanning is to experience the "feel good" feeling tanning salons have to offer. Researchers have found that ultraviolet (UV) radiation from tanning beds offers mood-enhancing effects that act as a treatment for seasonal affective disorder (SAD). SAD is when a person exhibits minor depression during seasonal changes, such as during the winter months. Ultraviolet radiation has been proven to increase the level of melatonin in the body. Melatonin plays a key role in sleep patterns and is suggested to reduce anxiety levels. Thus, those who go tanning experience a sense of relaxation afterwards. This sensation is what possibly drives tanners to continue tanning regardless of the health risks. More research needs to be done, but many researchers are beginning to add tanning to the list of addictive processes.
Research carried out on people undergoing treatment, as well as on the general population has revealed a negative correlation between age and addiction. As the age of people increases there is a lower number of shopping addicts. This data was confirmed by the 1999 European Report.
It must be noted that the age of diagnosis is much later than the age when the problems of addiction begin. Most addicts have the first symptoms of addiction in their twenties, but do not ask for help nor accept treatment until more than ten years afterwards. To explain the higher incidence of shopping addiction in young people, it has been shown that younger people have been born, and have grown up, in an increasingly consumerist society and they have endured the impact of publicity and marketing from birth. On the contrary, it is very unusual to find shopping addiction problems in people older than 65 years.
A conceptual model of PIU has been developed based on primary data collected from addiction researchers, psychologists, and health providers as well as older adolescents themselves. That study identified seven concepts, or clusters, that make up PIU using a concept mapping approach. These seven clusters are: psychosocial risk factors; physical impairment; emotional impairment; social and functional impairment; risky Internet use; impulsive Internet use; and Internet use dependence. The last three constructs have not been previously identified. Risky Internet use are behaviors that increase risks of adverse consequences. It is not just the amount of time spent on the Internet that puts an adolescent at risk; how the time is spent is also an important consideration. The impulsive use construct describes an inability to maintain balance or control of internet use in relation to everyday life. Finally, the dependent use construct reflects the more severe symptoms that are typically associated with addictions, such as withdrawal symptoms. Thus, internet addiction may represent a severe form of PIU.
Other research also stresses the fact that the Internet addiction disorder is not a unidimensional but a multidimensional construct. Various facets of Internet use must be differentiated because of their differential predictors, mechanisms and consequences. Online activities which, if done in person, would normally be considered troublesome, such as compulsive gambling, or shopping, are sometimes called "net compulsions".
As demonstrated by the chart below, numerous studies have examined factors which mediate substance abuse or dependence. In these examples, the predictor variables lead to the mediator which in turn leads to the outcome, which is always substance abuse or dependence. For example, research has found that being raised in a single-parent home can lead to increased exposure to stress and that increased exposure to stress, not being raised in a single-parent home, leads to substance abuse or dependence. The following are some, but by no means all, of the possible mediators of substance abuse.
As demonstrated by the chart below, numerous studies have examined factors which moderate substance abuse or dependence. In these examples, the moderator variable impacts the level to which the strength of the relationship varies between a given predictor variable and the outcome of substance abuse or dependence. For example, there is a significant relationship between psychobehavioral risk factors, such as tolerance of deviance, rebelliousness, achievement, perceived drug risk, familism, family church attendance and other factors, and substance abuse and dependence. That relationship is moderated by familism which means that the strength of the relationship is increased or decreased based on the level of familism present in a given individual.
Examples of mediators and moderators can be found in several empirical studies. For example, Pilgrim et al.’s hypothesized mediation model posited that school success and time spent with friends mediated the relationship between parental involvement and risk-taking behavior with substance use (2006). More specifically, the relationship between parental involvement and risk-taking behavior is explained via the interaction with third variables, school success and time spent with friends. In this example, increased parental involvement led to increased school success and decreased time with friends, both of which were associated with decreased drug use. Another example of mediation involved risk-taking behaviors. As risk-taking behaviors increased, school success decreased and time with friends increased, both of which were associated with increased drug use.
A second example of a mediating variable is depression. In a study by Lo and Cheng (2007), depression was found to mediate the relationship between childhood maltreatment and subsequent substance abuse in adulthood. In other words, childhood physical abuse is associated with increased depression, which in turn, in associated with increased drug and alcohol use in young adulthood. More specifically, depression helps to explain how childhood abuse is related to subsequent substance abuse in young adulthood.
A third example of a mediating variable is an increase of externalizing symptoms. King and Chassin (2008) conducted research examining the relationship between stressful life events and drug dependence in young adulthood. Their findings identified problematic externalizing behavior on subsequent substance dependency. In other words, stressful life events are associated with externalizing symptoms, such as aggression or hostility, which can lead to peer alienation or acceptance by socially deviant peers, which could lead to increased drug use. The relationship between stressful life events and subsequent drug dependence however exists via the presence of the mediation effects of externalizing behaviors.
An example of a moderating variable is level of cognitive distortion. An individual with high levels of cognitive distortion might react adversely to potentially innocuous events, and may have increased difficulty reacting to them in an adaptive manner (Shoal & Giancola, 2005). In their study, Shoal and Giancola investigated the moderating effects of cognitive distortion on adolescent substance use. Individuals with low levels of cognitive distortion may be more apt to choose more adaptive methods of coping with social problems, thereby potentially reducing the risk of drug use. Individuals with high levels of cognitive distortions, because of their increased misperceptions and misattributions, are at increased risk for social difficulties. Individuals may be more likely to react aggressively or inappropriately, potentially alienating themselves from their peers, thereby putting them at greater risk for delinquent behaviors, including substance use and abuse. In this study, social problems are a significant risk factor for drug use when moderated by high levels of cognitive distortions.
Kimberly Young indicates that previous research links internet/computer addiction with existing mental health issues, most notably depression. She states that computer addiction has significant effects socially such as low self-esteem, psychologically and occupationally which led many subjects to academic failure.
According to a Korean study on internet/computer addiction, pathological use of the internet results in negative life impacts such as job loss, marriage breakdown, financial debt, and academic failure. 70% of internet users in Korea are reported to play online games, 18% of which are diagnosed as game addicts which relates to internet/computer addiction. The authors of the article conducted a study using Kimberly Young's questionnaire. The study showed that the majority of those who met the requirements of internet/computer addiction suffered from interpersonal difficulties and stress and that those addicted to online games specifically responded that they hoped to avoid reality.
Not only are there significant health risks associated with compulsive hoarding, but scientists are also trying to pinpoint how significant the interference is with occupational and social functioning in a hoarder's daily life. In a pool of compulsive hoarders, 42% found their behavior problematic to the 63% of their family and friends who saw the behavior as problematic. The findings suggest that individuals who hoard may exhibit impaired sensitivity to their own and others’ emotions, and conversely, relate the world around them by forming attachments to possessions rather than to people. Lower emotional intelligence among hoarding patients may also impact their ability to discard and organize their possessions. With such detrimental characteristics, comprehensive research has been performed to find a cure. Although this is ongoing research, most investigations have found that only a third of patients who hoard show an adequate response to these medications and therapeutic interventions.
With the modifications to the DSM, insurance coverage for treatments will change as well as special education programs.
Some evidence based on brain lesion case studies also suggests that the anterior ventromedial prefrontal and cingulate cortices may be involved in abnormal hoarding behaviors, but sufferers of such injuries display less purposeful behavior than other individuals who hoard compulsively, thus making the involvement of these brain structures unclear. Other neuropsychological factors that have been found to be associated with individuals exhibiting hoarding behaviors include slower and more variable reaction times, increased impulsivity, and decreased spatial attention. A study comparing neural activity in hoarders, people with OCD, and a control group when deciding to throw possessions away found that when hoarders were trying to decide to throw away their own possessions, they had lower activity in the anterior cingulate cortex and insula regions of the brain. The study suggested this lower activity was related to "problems in identifying the emotional significance of a stimulus, generating appropriate emotional response, or regulating affective state during decision making." Hoarders had normal levels of activity in those regions when making decisions about possessions that did not belong to them.
The psychological and mental effects can prove intense and plague an individual for years. These include hopelessness, powerlessness, isolation, shame, depression, self-loathing, guilt, suicidal thoughts, suicide attempts, and/or self-injurious behaviors.
Diagnostic models do not currently include the criteria necessary to identify behaviors as addictions in a clinical setting. Behavioral addictions has been proposed as a new class in DSM-5, but the only category included is gambling addiction. Internet gaming addiction is included in the appendix as a condition for further study.
Behavioral addictions, which are sometimes referred to as impulse control disorders, are increasingly recognized as treatable forms of addiction.
The type of excessive behaviors identified as being addictive include gambling, food, sexual intercourse, use of pornography, use of computers, playing video games, use of the internet, exercise, and shopping.
Researching addiction to food, for example, a 2009 Scripps Research Institute study found evidence that the same molecular mechanisms correlated with human drug addiction also exist in compulsive overeating in obese rats. The dopamine D receptor studied is associated with vulnerability to drug addiction in humans. It was found downregulated in obese rats exposed to a high fat diet, and further reductions of the receptor increased compulsive eating. The D receptor responds to dopamine, a central neurotransmitter released in anticipation of rewarding, satiating experiences such as those involving food, sex or psychoactive drugs.
On August 15, 2011 the American Society of Addiction Medicine (ASAM) issued a public statement defining all addiction in terms of brain changes. "Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry."
The following excerpts are taken from the organization's FAQs: The new ASAM definition makes a departure from equating addiction with just substance dependence, by describing how addiction is also related to behaviors that are rewarding. This is the first time that ASAM has taken an official position that addiction is not solely "substance dependence." This definition says that addiction is about functioning and brain circuitry and how the structure and function of the brains of persons with addiction differ from the structure and function of the brains of persons who do not have addiction. It talks about reward circuitry in the brain and related circuitry, but the emphasis is not on the external rewards that act on the reward system. Food and sexual behaviors and gambling behaviors can be associated with the "pathological pursuit of rewards" described in this new definition of addiction.
We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or 'enough.' In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes ‘more’, which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors. So, anyone who has addiction is vulnerable to food and sex addiction.
Since ASAM released its statement, and shortly before its release, additional new studies have come out on Internet addiction. They reveal the same fundamental brain changes seen in other addicts of drugs. Another 2011 study found that the risk of Internet addiction in men was about three times more than women. Researchers noted, Internet addiction is a psychosocial disorder and its characteristics are as follows: tolerance, withdrawal symptoms, affective disorders, and problems in social relations. Internet usage creates psychological, social, school and/or work difficulties in a person's life. Eighteen percent of study participants were considered to be pathological Internet users, whose excessive use of the Internet was causing academic, social, and interpersonal problems. Excessive Internet use may create a heightened level of psychological arousal, resulting in little sleep, failure to eat for long periods, and limited physical activity, possibly leading to the user experiencing physical and mental health problems such as depression, OCD, low family relationships and anxiety.
Internet addiction disorder is not listed in the latest DSM manual (DSM-5, 2013), which is commonly used by psychiatrists. Gambling disorder is the only behavioural (non-substance related) addiction included in DSM-5. However Internet gaming disorder is listed in Section III, Conditions for Further Study, as a disorder requiring further study.
Jerald J. Block, M.D. has argued that Internet addiction should be included as a disorder in the DSM-5. However, Block observed that diagnosis was complicated because 86% of study subjects showing symptoms also exhibited other diagnosable mental health disorders.