Psycho-Behavioral Spiral of Disturbances in Prosocial Behavior, Stress Response, and Self-Regulation inSubstance-Related and Addictive Disorders

Abstract

Studies on neuropathological changes in substance-related and addictive disorders (SRADs) suggest that substance abuse or pathological gambling induces persistent abnormalities in the brain reward system that compromise emotional, decision making, and stress responses. Moreover, the enhancement of cortisol secretion resulting from long-term hyperactivation of the stress response is thought to impair the self-regulating system that controls emotion and executive function. In contrast, oxytocin induces prosocial behavior, attenuates the stress response, and reduces addictive behaviors in laboratory animals and humans. Prosocial behavior, a major coping response for stress in humans, is believed to be related to reward system function. Cognitive-behavioral therapy (CBT) is reported to lessen some symptoms of SRADs by affecting the function of the prefrontal cortex. Taken together these findings suggest that abnormalities of the reward system trigger the psycho-behavioral spiral of disturbances in prosocial behavior, the stress response, and self-regulation that are associated with SRADs. It is proposed that CBT in combination with drugs known to modulate prosocial behavior and the stress response could be of therapeutic value in the treatment of SRADs.

Alterations in Brain Neural Network and Stress System in Atopic Dermatitis: Novel Therapeutic Interventions

“…The dopamine-containing substantia nigra pars compacta neurons project to the dorsal striatum and plays a critical role as the habit learning system to regulate habitual responses such as persistent scratching behavior (Smith and Graybiel, 2016). Substance-related and addictive disorders, including drug abuse and compulsive gambling, can be viewed as a consequence of aberrant habit-based learning resulting from disturbances in the reward, emotional, decision making, and stress response systems (American Psychiatric Association, DSM5, 2013;Nakagawa, 2017). These suggest that intense itch related to inflammation and lesions in the skin induces itch-scratch circuit activation and resultant scratching behavior, which can stimulate dopaminergic reward and habit learning systems, with reinforcement of habitual scratching behavior in atopic dermatitis patients (Fig.…”

“…Role of the Dorsolateral Prefrontal Cortex. The dorsolateral prefrontal cortex is essential in regulating the other brain areas, such as the amygdala, hippocampus, thalamus, dorsal striatum, nucleus accumbens, and different cerebral cortexes to maintain quality of life, well-being, executive function, and cognition (Heatherton and Wagner, 2011;Morris et al, 2016;Nakagawa, 2017). When administered histamine to evoke itch sensation, transient activation of the somatosensory cortex and motor cortex with no changes in dorsolateral prefrontal cortex activity is observed in healthy subjects (Ishiuji et al, 2009).…”

“…It is proposed that "uncontrollable" mood changes are likely related to such dysregulation of the dorsolateral prefrontal cortex control of the emotional system including the amygdala (Nakagawa and Chiba, 2014;. Impaired dorsolateral prefrontal cortex regulation of the decision making, reward, habit learning, and emotional systems can be induced in substance-related and addictive disorders with "uncontrollable" drug use or gambling (Nakagawa, 2017). Schizophrenia and autism spectrum disorder patients experience social cognitive deficits or "uncontrollable" social cognition correlating with dysregulation of the dorsolateral prefrontal cortex control of the social brain network, such as the thalamus, superior temporal gyrus, and superior temporal sulcus (Nakagawa and Chiba, 2016).…”

“…Itch is the most frequent and debilitating symptom of atopic dermatitis (Trier and Kim, 2018;Misery et al, 2019). The brain regions, including thalamus, somatosensory cortex, and motor cortex, are responsible for itch signal transmission and scratching behavior outputs (Mochizuki et al, 2017), whereas the prefrontal cortex, especially dorsolateral prefrontal cortex, is essential in controlling these brain areas and maintaining quality of life, well-being, and a set of cognitive processes, such as executive functions and social cognitive responses (Heatherton and Wagner, 2011;Nakagawa, 2017). Under histamineor allergen-induced acute itch condition, healthy subjects display activation of the somatosensory cortex and motor cortex with no changes in dorsolateral prefrontal cortex activity, while in atopic dermatitis patients, activation of the dorsolateral prefrontal cortex and unchanged activity of the somatosensory and motor cortexes are observed, with dorsolateral prefrontal cortex activity positively correlating with disease severity and being negatively associated with perceived itch (Ishiuji et al, 2009;Desbordes et al, 2015).…”

“…It is hypothesized that dysregulation of the dorsolateral prefrontal cortex control of the other brain regions is associated with, and possibly responsible for, some symptoms of neuropsychiatric disorders (Nakagawa, 2017;Nakagawa and Yamada, 2020;2022). Patients with major depressive disorder experience dorsolateral prefrontal cortex disruption correlating with catastrophizing about psychiatric symptoms because of irrational interpretations of experience and negative beliefs, referred to as cognitive distortion (Nakagawa and Chiba, 2014).…”