Drive, reward sensitivity and the flattening of both.
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Classical works
كتب التراث6 shownArabic originals, reached through the subject’s Arabic senses. Interpretive sources, never proof of a ruling.
mukhtasar-minhaj §321mukhtasar-minhajArabic sense: الفتور, الكسل, فتور, كسل
ومن آدابه: أن لا يمتلئ من الطعام فى الليل، بل يأكل بمقدار، فانه ما ملأ ابن آدم وعاء شرا من بطن. ومتى شبع أول الليل لم ينتفع بنفسه فى باقيه، وكذلك إذا شبع وقت السحر لم ينتفع بنفسه إلى قريب من الظهر، لأن كثرة الأكل تورث الكسل والفتور، ثم يفوت المقصود من الصيام بكثرة الأكل، لأن المراد منه أن يذوق طعم الجوع، ويكون تاركا للمشتهى.
madarij §3757madarijArabic sense: الفتور, الكسل, فتور, كسل
بين القبض والبسط أي ينقطع إلى صحبة الحال وهو الوارد الذي يرد على القلب من تأثيره بالمعاملة السالب لوصف الكسل والفتور الجالب له إلى مرافقة الرفيق الأعلى الذين أنعم الله عليهم فينتقل من مقام العلم إلى مقام الكشف ومن مقام رسوم الأعمال إلى مقام حقائقها وأذواقها ومواجيدها وأحوالها فيترقى من الإسلام إلى الإيمان ومن الإيمان إلى الإحسان
wabil-sayyib §43wabil-sayyibArabic sense: الفتور, الكسل, فتور, كسل
فحقيقة التعظيم للامر والنهي ان لا يعارضا بترخص جاف ولا يعرضا لتشديد غال فان المقصود هو الصراط المستقيم الموصل إلى الله عز وجل بسالكه وما امر الله عز وجل بأمر الا وللشيطان فيه نزغتان اما تقصير وتفريط واما افراط وغلو فلا يبالي بما ظفر من العبد من الخطيئتين فانه ياتي إلى قلب العبد فيستامه فان وجد فيه فتورا وتوانيا وترخيصا اخذه من هذه الخطة فثبطه واقعده وضربه بالكسل والتواني والفتور وفتح له باب التاويلات والرجاء وغير ذلك حتى ربما ترك العبد المامور جملة
fawaid §490fawaidArabic sense: الفتور, الكسل, فتور, كسل
العزيمة فيصدقه في عزمه وفي فعله قال تعالى فإذا عزم الأمر فلو صدقوا الله لكان خيرا لهم فسعادته في صدق العزيمة وصدق الفعل فصدق العزيمة جمعها وجزمها وعدم التردد فيها بل تكون عزيمة لا يشوبها تردد ولا تلوم فإذا صدقت عزيمته بقى عليه صدق الفعل وهو استفراغ الوسع وبذل الجهد فيه وأن لا يتخلف عنه بشيء من ظاهره وباطنه فعزيمة القصد تمنعه من ضعف الإرادة والهمة وصدق الفعل يمنعه من الكسل والفتور ومن صدق الله في جميع أموره صنع الله له فوق ما يصنع لغيره وهذا الصدق معنى يلتئم من صحة الإخلاص وصدق التوكل فأصدق الناس من صح إخلاصه وتوكله
madarij §6757madarijArabic sense: الفتور, الكسل, فتور, كسل
فالإيمان بالصفات ومعرفتها وإثبات حقائقها وتعلق القلب بها وشهوده لها هو مبدأ الطريق ووسطه وغايته وهو روح السالكين وحاديهم إلى الوصول ومحرك عزماتهم إذا فتروا ومثير هممهم إذا قصروا فإن سيرهم إنما هو على الشواهد فمن كان لا شاهد له فلا سير له ولا طلب ولا سلوك له وأعظم الشواهد صفات محبوبهم ونهاية مطلوبهم وذلك هو العلم الذي رفع لهم في السير فشمروا إليه كما قالت عائشة رضي الله عنها من رأى رسول الله فقد رآه غاديا رائحا لم يضع لبنة على لبنة ولكن رفع له علم فشمر إليه ولا يزال العبد في التواني والفتور والكسل حتى يرفع الله عز وجل له بفضله ومنه علما يشاهده بقلبه فيشمر إليه ويعمل عليه
madarij §1930madarijArabic sense: الفتور, الكسل, فتور, كسل
قال الله تعالى : ففروا إلى الله الذاريات : 50 ] وحقيقة الفرار : الهرب من شيء إلى شيء وهو نوعان : فرار السعداء وفرار الأشقياء ففرار السعداء : الفرار إلى الله عز وجل وفرار الأشقياء : الفرار منه لا إليه وأما الفرار منه إليه : ففرار أوليائه قال ابن عباس في قوله تعالى : ففروا إلى الله الذاريات : 50 ] : فروا منه إليه واعملوا بطاعته وقال سهل بن عبدالله : فروا مما سوى الله إلى الله وقال آخرون : اهربوا من عذاب الله إلى ثوابه بالإيمان والطاعة وقال صاحب المنازل : هو الهرب مما لم يكن إلى من لم يزل وهو على ثلاث درجات : فرار العامة من الجهل إلى العلم عقدا وسعيا ومن الكسل إلى التشمير جدا وعزما ومن الضيق إلى السعة ثقة ورجاء يريد بما لم يكن الخلق وبما لم يزل الحق وقوله : فرار العامة : من الجهل إلى العلم عقدا وسعيا الجهل نوعان : عدم العلم بالحق النافع وعدم العمل بموجبه ومقتضاه فكلاهما جهل لغة وعرفا وشرعا وحقيقة قال موسى : أعوذ بالله أن أكون من الجاهلين البقره : 67 ] لما قال له قومه : أتتخذنا هزوا البقره :
Research library, full list
501 to 525 of 1,483Reappraising striatal D1- and D2-neurons in reward and aversion.
The striatum has been involved in complex behaviors such as motor control, learning, decision-making, reward and aversion. The striatum is mainly composed of medium spiny neurons (MSNs), typically divided into those expressing dopamine receptor D1, forming the so-called direct pathway, and those expressing D2 receptor (indirect pathway). For decades it has been proposed that these two populations exhibit opposing control over motor output, and recently, the same dichotomy has been proposed for valenced behaviors. Whereas D1-MSNs mediate reinforcement and reward, D2-MSNs have been associated with punishment and aversion. In this review we will discuss pharmacological, genetic and optogenetic studies that indicate that there is still controversy to what concerns the role of striatal D1- and D2-MSNs in this type of behaviors, highlighting the need to reconsider the early view that they medi…
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Interactions between the endocannabinoid and nicotinic cholinergic systems: preclinical evidence and therapeutic perspectives.
Rationale: Several lines of evidence suggest that endocannabinoid and nicotinic cholinergic systems are implicated in the regulation of different physiological processes, including reward, and in the neuropathological mechanisms of psychiatric diseases, such as addiction. A crosstalk between these two systems is substantiated by the overlapping distribution of cannabinoid and nicotinic acetylcholine receptors in many brain structures.
Objective: We will review recent preclinical data showing how the endocannabinoid and nicotinic cholinergic systems interact bidirectionally at the level of the brain reward pathways, and how this interaction plays a key role in modulating nicotine and cannabinoid intake and dependence.
Results: Many behavioral and neurochemical effects of nicotine that are related to its addictive potential are reduced by pharmacological blockade or genetic deletion of typ…
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Garland EL (2016)reviewMEDLINE-indexed journal, not yet read by usAnnals of the New York Academy of Sciences90 citations Restructuring reward processing with Mindfulness-Oriented Recovery Enhancement: novel therapeutic mechanisms to remediate hedonic dysregulation in addiction, stress, and pain.
Though valuation processes are fundamental to survival of the human species, hedonic dysregulation is at the root of an array of maladies, including addiction, stress, and chronic pain, as evidenced by the allostatic shift in the relative salience of natural reward to drug reward observed among persons with severe substance use disorders. To address this crucial problem, novel interventions are needed to restore hedonic regulatory processes gone awry in persons exhibiting addictive behaviors. This article describes a theoretical rationale and empirical evidence for the effects of one such new intervention, Mindfulness-Oriented Recovery Enhancement (MORE), on top-down and bottom-up mechanisms implicated in cognitive control and hedonic regulation. MORE is innovative and distinct from extant mindfulness-based interventions in that it unites traditional mindfulness meditation with reapprais…
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Argument for a non-linear relationship between severity of human obesity and dopaminergic tone.
Alterations in the dopaminergic system have been implicated in both animal and human obesity. However, to date, a comprehensive model on the nature and functional relevance of this relationship is missing. In particular, human data remain equivocal in that seemingly inconsistent reports exist of positive, negative or even no relationships between dopamine D2/D3 receptor availability in the striatum and measures of obesity. Further, data on receptor availability have been commonly interpreted as reflecting receptor density, despite the possibility of an alternative interpretation, namely alterations in the basal levels of endogenous dopaminergic tone. Here, we provide a unifying framework that is able to explain the seemingly contradictory findings and offer an alternative and novel perspective on existing data. In particular, we suggest (i) a quadratic relationship between alterations in…
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Schultz W (2015)reviewMEDLINE-indexed journal, not yet read by usPhysiological reviews639 citations Neuronal Reward and Decision Signals: From Theories to Data.
Rewards are crucial objects that induce learning, approach behavior, choices, and emotions. Whereas emotions are difficult to investigate in animals, the learning function is mediated by neuronal reward prediction error signals which implement basic constructs of reinforcement learning theory. These signals are found in dopamine neurons, which emit a global reward signal to striatum and frontal cortex, and in specific neurons in striatum, amygdala, and frontal cortex projecting to select neuronal populations. The approach and choice functions involve subjective value, which is objectively assessed by behavioral choices eliciting internal, subjective reward preferences. Utility is the formal mathematical characterization of subjective value and a prime decision variable in economic choice theory. It is coded as utility prediction error by phasic dopamine responses. Utility can incorporate…
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Role of Dopamine Neurons in Reward and Aversion: A Synaptic Plasticity Perspective.
The brain is wired to predict future outcomes. Experience-dependent plasticity at excitatory synapses within dopamine neurons of the ventral tegmental area, a key region for a broad range of motivated behaviors, is thought to be a fundamental cellular mechanism that enables adaptation to a dynamic environment. Thus, depending on the circumstances, dopamine neurons are capable of processing both positive and negative reinforcement learning strategies. In this review, we will discuss how changes in synaptic plasticity of dopamine neurons may affect dopamine release, as well as behavioral adaptations to different environmental conditions falling at opposite ends of a saliency spectrum ranging from reward to aversion.
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Parallel basal ganglia circuits for voluntary and automatic behaviour to reach rewards.
The basal ganglia control body movements, value processing and decision-making. Many studies have shown that the inputs and outputs of each basal ganglia structure are topographically organized, which suggests that the basal ganglia consist of separate circuits that serve distinct functions. A notable example is the circuits that originate from the rostral (head) and caudal (tail) regions of the caudate nucleus, both of which target the superior colliculus. These two caudate regions encode the reward values of visual objects differently: flexible (short-term) values by the caudate head and stable (long-term) values by the caudate tail. These value signals in the caudate guide the orienting of gaze differently: voluntary saccades by the caudate head circuit and automatic saccades by the caudate tail circuit. Moreover, separate groups of dopamine neurons innervate the caudate head and tail…
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The Brain on Drugs: From Reward to Addiction.
Advances in neuroscience identified addiction as a chronic brain disease with strong genetic, neurodevelopmental, and sociocultural components. We here discuss the circuit- and cell-level mechanisms of this condition and its co-option of pathways regulating reward, self-control, and affect. Drugs of abuse exert their initial reinforcing effects by triggering supraphysiologic surges of dopamine in the nucleus accumbens that activate the direct striatal pathway via D1 receptors and inhibit the indirect striato-cortical pathway via D2 receptors. Repeated drug administration triggers neuroplastic changes in glutamatergic inputs to the striatum and midbrain dopamine neurons, enhancing the brain's reactivity to drug cues, reducing the sensitivity to non-drug rewards, weakening self-regulation, and increasing the sensitivity to stressful stimuli and dysphoria. Drug-induced impairments are long …
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Irrational beliefs, biases and gambling: exploring the role of animal models in elucidating vulnerabilities for the development of pathological gambling.
Gambling is a heterogeneous and complex disorder. Multiple factors may lead to problem gambling, yet one of the most important appears to be the increased presence of cognitive biases or distortions. These biases are thought to precipitate gambling as they can lead to dysfunctional decision making under risk or ambiguity. Modelling these cognitive perturbations in animals can improve our understanding of their neurobiological bases, and potentially stimulate novel treatment options. The first aim of this review is to give a broad overview of some of the cognitive biases that are most commonly associated with gambling. Secondly, we will discuss several animal models that we have developed in which rodent decision-making appears hallmarked by the same cognitive inconsistencies as human choice. In particular, we will discuss two tasks that capture elements of risk and loss averse decision m…
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Dopamine Prediction Errors in Reward Learning and Addiction: From Theory to Neural Circuitry.
Midbrain dopamine (DA) neurons are proposed to signal reward prediction error (RPE), a fundamental parameter in associative learning models. This RPE hypothesis provides a compelling theoretical framework for understanding DA function in reward learning and addiction. New studies support a causal role for DA-mediated RPE activity in promoting learning about natural reward; however, this question has not been explicitly tested in the context of drug addiction. In this review, we integrate theoretical models with experimental findings on the activity of DA systems, and on the causal role of specific neuronal projections and cell types, to provide a circuit-based framework for probing DA-RPE function in addiction. By examining error-encoding DA neurons in the neural network in which they are embedded, hypotheses regarding circuit-level adaptations that possibly contribute to pathological er…
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Frank GK (2015)reviewMEDLINE-indexed journal, not yet read by usCNS spectrums100 citations Advances from neuroimaging studies in eating disorders.
Over the past decade, brain imaging has helped to better define eating disorder-related brain circuitry. Brain research on gray matter (GM) and white matter (WM) volumes had been inconsistent, possibly due to the effects of acute starvation, exercise, medication, and comorbidity, but newer studies have controlled for such effects. Those studies suggest larger left medial orbitofrontal gyrus rectus volume in ill adult and adolescent anorexia nervosa after recovery from anorexia nervosa, and in adult bulimia nervosa. The orbitofrontal cortex is important in terminating food intake, and altered function could contribute to self-starvation. The right insula, which processes taste but also interoception, was enlarged in ill adult and adolescent anorexia nervosa, as well as adults recovered from the illness. The fixed perception of being fat in anorexia nervosa could be related to altered insu…
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Habitual alcohol seeking: modeling the transition from casual drinking to addiction.
The transition from goal-directed actions to habitual ethanol seeking models the development of addictive behavior that characterizes alcohol use disorders. The progression to habitual ethanol-seeking behavior occurs more rapidly than for natural rewards, suggesting that ethanol may act on habit circuit to drive the loss of behavioral flexibility. This review will highlight recent research that has focused on the formation and expression of habitual ethanol seeking, and the commonalities and distinctions between ethanol and natural reward-seeking habits, with the goal of highlighting important, understudied research areas that we believe will lead toward the development of novel treatment and prevention strategies for uncontrolled drinking.
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Impulsive action and impulsive choice across substance and behavioral addictions: cause or consequence?
Substance use disorders are prevalent and debilitating. Certain behavioral syndromes ('behavioral addictions') characterized by repetitive habits, such as gambling disorder, stealing, shopping, and compulsive internet use, may share clinical, co-morbid, and neurobiological parallels with substance addictions. This review considers overlap between substance and behavioral addictions with a particular focus on impulsive action (inability to inhibit motor responses), and impulsive choice (preference for immediate smaller rewards to the detriment of long-term outcomes). We find that acute consumption of drugs with abuse potential is capable of modulating impulsive choice and action, although magnitude and direction of effect appear contingent on baseline function. Many lines of evidence, including findings from meta-analyses, show an association between chronic drug use and elevated impulsiv…
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Starkstein SE (2014)reviewMEDLINE-indexed journal, not yet read by usCortex; a journal devoted to the study of the nervous system and behavior159 citations Anosognosia in Alzheimer's disease: diagnosis, frequency, mechanism and clinical correlates.
Anosognosia is present in a large proportion of patients with mild Alzheimer's disease (AD), and its frequency increases with the progression of the illness. Several instruments have been validated to assess anosognosia in AD, but there is no consensus regarding the best diagnostic strategy. Anosognosia in AD is a significant predictor of apathy and is significantly related to lower depression and anxiety scores, more severe caregiver burden and dangerous behaviours. Studies using different imaging modalities have demonstrated an association between anosognosia and dysfunction in frontal, temporomedial and temporoparietal regions. The mechanism of anosognosia remains unknown, but it has been explained as a consequence of deficits of encoding and updating biographical memory, and dysfunction of comparator, executive and metacognitive systems.
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Interoception and drug addiction.
The role of interoception and its neural basis with relevance to drug addiction is reviewed. Interoception consists of the receiving, processing, and integrating body-relevant signals with external stimuli to affect ongoing motivated behavior. The insular cortex is the central nervous system hub to process and integrate these signals. Interoception is an important component of several addiction relevant constructs including arousal, attention, stress, reward, and conditioning. Imaging studies with drug-addicted individuals show that the insular cortex is hypo-active during cognitive control processes but hyperactive during cue reactivity and drug-specific, reward-related processes. It is proposed that interoception contributes to drug addiction by incorporating an "embodied" experience of drug uses together with the individual's predicted versus actual internal state to modulate approach…
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Reward processing in obesity, substance addiction and non-substance addiction.
Similarities and differences between obesity and addiction are a prominent topic of ongoing research. We conducted an activation likelihood estimation meta-analysis on 87 studies in order to map the functional magnetic resonance imaging (fMRI) response to reward in participants with obesity, substance addiction and non-substance (or behavioural) addiction, and to identify commonalities and differences between them. Our study confirms the existence of alterations during reward processing in obesity, non-substance addiction and substance addiction. Specifically, participants with obesity or with addictions differed from controls in several brain regions including prefrontal areas, subcortical structures and sensory areas. Additionally, participants with obesity and substance addictions exhibited similar blood-oxygen-level-dependent fMRI hyperactivity in the amygdala and striatum when proce…
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Emotional and behavioral symptoms in neurodegenerative disease: a model for studying the neural bases of psychopathology.
Disruptions in emotional, cognitive, and social behavior are common in neurodegenerative disease and in many forms of psychopathology. Because neurodegenerative diseases have patterns of brain atrophy that are much clearer than those of psychiatric disorders, they may provide a window into the neural bases of common emotional and behavioral symptoms. We discuss five common symptoms that occur in both neurodegenerative disease and psychopathology (i.e., anxiety, dysphoric mood, apathy, disinhibition, and euphoric mood) and their associated neural circuitry. We focus on two neurodegenerative diseases (i.e., Alzheimer's disease and frontotemporal dementia) that are common and well characterized in terms of emotion, cognition, and social behavior and in patterns of associated atrophy. Neurodegenerative diseases provide a powerful model system for studying the neural correlates of psychopatho…
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Hungry for reward: How can neuroscience inform the development of treatment for Anorexia Nervosa?
Dysfunctional reward from the pursuit of thinness presents a major challenge to recovery from Anorexia Nervosa (AN). We explore the neuroscientific basis of aberrant reward in AN, with the aim of generating novel hypotheses for translational investigation, and elucidate disease mechanisms to inform the development of targeted interventions. Relevant neuroimaging and behavioural studies are reviewed. These suggest that altered eating in AN may be a consequence of aberrant reward processing combined with exaggerated cognitive control. We consider evidence that such aberrant reward processing is reflected in the compulsive behaviours characterising AN, with substantial overlap in the neural circuits implicated in reward processing and compulsivity. Drawing on contemporary neuroscientific theories of substance dependence, processes underpinning the shift from the initially rewarding pursuit …
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The addictive dimensionality of obesity.
Our brains are hardwired to respond and seek immediate rewards. Thus, it is not surprising that many people overeat, which in some can result in obesity, whereas others take drugs, which in some can result in addiction. Though food intake and body weight are under homeostatic regulation, when highly palatable food is available, the ability to resist the urge to eat hinges on self-control. There is no homeostatic regulator to check the intake of drugs (including alcohol); thus, regulation of drug consumption is mostly driven by self-control or unwanted effects (i.e., sedation for alcohol). Disruption in both the neurobiological processes that underlie sensitivity to reward and those that underlie inhibitory control can lead to compulsive food intake in some individuals and compulsive drug intake in others. There is increasing evidence that disruption of energy homeostasis can affect the r…
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Does a shared neurobiology for foods and drugs of abuse contribute to extremes of food ingestion in anorexia and bulimia nervosa?
Is starvation in anorexia nervosa (AN) or overeating in bulimia nervosa (BN) a form of addiction? Alternatively, why are individuals with BN more vulnerable and individuals with AN protected from substance abuse? Such questions have been generated by recent studies suggesting that there are overlapping neural circuits for foods and drugs of abuse. To determine whether a shared neurobiology contributes to eating disorders and substance abuse, this review focused on imaging studies that investigated response to tastes of food and tasks designed to characterize reward and behavioral inhibition in AN and BN. BN and those with substance abuse disorders may share dopamine D2 receptor-related vulnerabilities, and opposite findings may contribute to "protection" from substance abuse in AN. Moreover, imaging studies provide insights into executive corticostriatal processes related to extraordinar…
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Spear LP (2013)reviewMEDLINE-indexed journal, not yet read by usThe Journal of adolescent health : official publication of the Society for Adolescent Medicine450 citations Adolescent neurodevelopment.
Purpose: The purpose of this article is to outline notable alterations occurring in the adolescent brain, and to consider potential ramifications of these developmental transformations for public policy and programs involving adolescents.
Methods: Developmental changes in the adolescent brain obtained from human imaging work are reviewed, along with results of basic science studies.
Results: Adolescent brain transformations include both progressive and regressive changes that are regionally specific and serve to refine brain functional connectivity. Along with still-maturing inhibitory control systems that can be overcome under emotional circumstances, the adolescent brain is associated with sometimes elevated activation of reward-relevant brain regions, whereas sensitivity to aversive stimuli may be attenuated. At this time, the developmental shift from greater brain plasticity early in…
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The hippocampal-prefrontal pathway: the weak link in psychiatric disorders?
While the hippocampal formation and the prefrontal cortex each have a well-established role in cognitive and mnemonic processes, the extent and manner in which these structures interact to achieve these functions has not been fully delineated. Recent research in rodents compellingly supports the idea that the projection of neurons extending from the CA1 region of the hippocampus and from the subiculum to the prefrontal cortex, referred to here as the H-PFC pathway, is critically involved in aspects of cognition related to executive function and to emotional regulation. Concurrently, it is becoming evident that persons suffering from schizophrenia, depression, and post-traumatic stress disorder display structural anomalies and aberrant functional coupling within the hippocampal-prefrontal circuit. Considering that these disorders involve varying degrees of cognitive impairment and emotion…
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Schultz W (2013)reviewMEDLINE-indexed journal, not yet read by usCurrent opinion in neurobiology454 citations Updating dopamine reward signals.
Recent work has advanced our knowledge of phasic dopamine reward prediction error signals. The error signal is bidirectional, reflects well the higher order prediction error described by temporal difference learning models, is compatible with model-free and model-based reinforcement learning, reports the subjective rather than physical reward value during temporal discounting and reflects subjective stimulus perception rather than physical stimulus aspects. Dopamine activations are primarily driven by reward, and to some extent risk, whereas punishment and salience have only limited activating effects when appropriate controls are respected. The signal is homogeneous in terms of time course but heterogeneous in many other aspects. It is essential for synaptic plasticity and a range of behavioural learning situations.
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Waddell S (2013)reviewMEDLINE-indexed journal, not yet read by usCurrent opinion in neurobiology201 citations Reinforcement signalling in Drosophila; dopamine does it all after all.
Reinforcement systems are believed to drive synaptic plasticity within neural circuits that store memories. Recent evidence from the fruit fly suggests that anatomically distinct dopaminergic neurons ultimately provide the key instructive signals for both appetitive and aversive learning. This dual role for dopamine overturns the previous model that octopamine signalled reward and dopamine punishment. More importantly, this anatomically segregated double role for dopamine in reward and aversion mirrors that emerging in mammals. Therefore, an antagonistic organization of distinct reinforcing dopaminegic neurons is a conserved feature of brains. It now seems crucial to understand how the dopaminergic neurons are controlled and what the released dopamine does to the underlying circuits to convey opposite valence.
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Phenomenology and treatment of behavioural addictions.
Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made.
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