Cue-reactivity responses in addictive behaviours are triggered by cues associated with the addictive activity itself. Although such cues may depict the rewarding aspects of the behaviour, responses may also generalise to more distal cues that do not directly convey this content.

To examine cue reactivity to distal cues (i.e. devices displaying starting or log-in screens of internet applications) in a diagnostically validated sample of individuals with specific problematic usage of the internet (PUIs) and determine whether laboratory-measured cue reactivity predicts real-life behavioural engagement and temptation experiences, in addition to differences across PUI stages and cue types.

In this preregistered study, data were collected from October 2021 to 31 August 2024 from individuals with non-problematic (n = 268), risky (n = 135) and pathological (n = 133) engagement in specific internet activities (gaming, buying and/or shopping, pornography use and social networking). Participants were aged 18–65 years (mean age 26.12 years, s.d. 6.79), and 44.6% were female. A cue-reactivity paradigm with distal cues showing target and non-target internet activities was used. A within–between participants design was used, with repeated measures analyses of variance. Correlations between laboratory cue-reactivity measures and measures from a 14-day end-of-day assessment in the natural environment are reported.

Heightened cue reactivity (arousal, urge and/or craving) was observed in individuals with risky and pathological use compared with those with non-problematic use across all levels of the paradigm. Individuals with pathological use showed elevated levels of urge and craving, along with generalised responses to stimuli showing starting and/or log-in screens not related to their specific (addictive) behaviour. These effects were consistent across different types of PUI and were associated with engagement in the behaviour and temptation experiences in naturalistic settings.

These findings indicate that cue reactivity and craving are central aspects of PUIs. Although different devices may elicit different types of action, our results highlight the challenges of regulating behaviour in environments saturated with unavoidable triggers, such as internet content and devices.

Despite the growing interest in addiction research, which demonstrates the potential predictive role of adverse childhood experiences (ACEs), little is known about their impact on the psychological symptoms of craving.

After reviewing the relevant diagnostic criteria for addiction and comorbid mental disorders along with routinely collected clinical and service-use data, 208 outpatients were assessed on the study protocol. Following the recruitment phase, nominal and ordinal data were analyzed using nonparametric methods.

Most of the outpatients reported ACEs (89.1%) and experienced cravings (73.4–95.7%). A positive association between ACEs and either intention and preplanning (r = .14, p < .05) or lack of control (r = .15; p < .05) of the craving behavior was found.

Craving behavior in addiction remains a subject of debate. Although correlation analyses showed significant associations between reported ACEs and measures of craving, they were relatively small.

Les addictions comportementales (AC), ou addictions sans drogues, ont en commun la perte de contrôle sur le comportement et la poursuite de ce comportement malgré les dommages. Les principales AC sont : le jeu pathologique, l’addiction sexuelle, l’exercice physique excessif, les achats compulsifs et certains troubles du comportement alimentaire. Associées à des comorbidités psychiatriques et addictives, à des conséquences sociales, leur prise en charge repose essentiellement sur des psychothérapies et des mesures sociales. L’utilisation des techniques de stimulation cérébrale est encore relativement récente, notamment dans le champ des addictions. La tDCS a principalement été testée dans les addictions avec substances, mais très peu dans les AC. Cette revue de la littérature a pour objectif de faire une mise au point méthodologique et clinique sur les premiers travaux couvrant cette question.

Une recherche bibliographique a été réalisée sur Pubmed et ScienceDirect, jusqu’au 30 juillet 2014. Les critères d’inclusion étaient : articles de revue, articles didactiques, essais thérapeutiques, études physiopathologiques.

Quatorze revues et études ont été retenues. Elles portent sur les troubles du comportement alimentaire, l’obésité, et les processus décisionnels et de prise de risque. Les études cliniques ont montré l’intérêt de la tDCS bilatérale dans la diminution de la prise de risque, et du craving alimentaire. La tDCS présente des avantages prometteurs dans le traitement des AC. Non invasive, bien tolérée, avec un dispositif portable, peu coûteuse comparée à la TMS, elle pourrait être dispensée dans un cadre ambulatoire.

Quetiapine is a novel antipsychotic, which is efficacious in the treatment of positive and negative symptoms in schizophrenia. Research has shown that atypical antipsychotic also reduce the craving and consumption for stimulants and alcohol. Due to Quetiapine's particulars and the promising receptor profile concerning addiction medicine, we set out to examine the tolerability and efficacy concerning relapse prevention of withdrawn alcoholics suffering from craving and affective symptoms.

Our case observations attempted to evaluate nine alcoholics after withdrawal suffering from persisting craving, sleep disorder, excitement, depressive symptoms or anxiety symptoms. The patients were treated with quetiapine as relapse prevention and we followed them up in our outpatient clinic.

Eight out of nine patients were abstinent under quetiapine over a period of 2–7 months. One of these patients relapsed after he stopped taking the preparation at his own initiative after 10 weeks. The ninth patient stopped taking the preparation immediately because of swollen nasal mucosae. All target symptoms disappeared in the patients after an average of (mean ± S.D.) 24.5 ± 18.1 days. The overall tolerability was considered to be very good; however, initial sleepiness appeared in four patients.

Although uncontrolled case observations can only be interpreted with caution quetiapine seems to deserve further investigation and may hold the potential for preventing alcohol relapse in alcoholics suffering from additional above-mentioned symptoms.

In this cross-sectional study we compared alcohol-dependent smokers and non-alcohol-dependent smokers with respect to intensity of nicotine dependence, craving conditions, sleep disturbances, comorbidity with major depression, reasons for smoking, accompanying somatic diseases and patients' prolonged abstinence from smoking during the 3 years preceding the study.

Fifty-one alcohol-dependent smokers and 327 non-alcohol-dependent smokers diagnosed as ICD-10 and DSM-IV-nicotine dependent, were investigated by means of the Fagerström Test for Nicotine Dependence, the Lübeck Craving-Recurrence Risk Questionnaire and the Lesch Alcohol Dependence Typology (both adapted to smoking).

The intensity of nicotine dependence was more enhanced in alcohol-dependent smokers compared to non-alcohol-dependent smokers. Several variables of all factors of craving (“depressive mood”, “stimulation”, “relaxation”, “socially triggered tension”) were significantly increased in alcohol-dependent patients (P < 0.05). Alcohol-dependent smokers showed depressive symptoms and sleep disturbances, whilst non-alcohol-dependent individuals mainly smoked for stress release and weight control.

Our study demonstrates that the intensity of nicotine dependence, several conditions of craving for nicotine, sleep disturbances and symptoms of depression appear to be enhanced in alcohol-dependent smokers compared with non-alcohol-dependent smokers.

It is hoped that the factors of craving and reasons for smoking identified in this study will contribute to a better understanding of smoking temptation in alcohol-dependent smokers and non-alcohol-dependent smokers in future.

In the past decade, neurobiological research on pathological gambling has flourished. Based on neurobiological similarities between pathological gambling and substance use disorders and similarities in genetics, diagnostic criteria, and effective treatments, pathological gambling was the first behavioral addiction to be included in the DSM-5 within the revised category Substance-related and addictive disorders.

In this presentation novel findings from gambling research in our research group focusing on the role of impulsivity, anticipation towards monetary outcomes, and the interaction between stress and cue reactivity will be presented, with a focus on new functional MRI results. An overview will be given on the concepts of impulsivity and compulsivity in pathological gambling and relevant neurocognitive and neuroimaging findings. Implications of neurobiological research for novel intervention research, such as in neuromodulation studies and personalized medicine will be highlighted.

The authors have not supplied their declaration of competing interest.

Gambling disorder (GD) is common and disabling addictive disorder. In patients with substance use disorders, the application of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers promise to alleviate craving. We hypothesized that applying real compared to sham rTMS over the left DLPFC would reduce gambling craving in patients with GD.

In a randomized sham-controlled crossover design, 22 treatment-seeking patients with GD received real or sham treatment with high frequency rTMS over the left DLPFC followed a week later by the other type of treatment. Before and after each rTMS session, participants rated their gambling craving (from 0 to 100) before and after viewing a gambling video used as a cue. We used the Yale-Brown Obsessive Compulsive Scale adapted for Pathological Gambling to assess gambling behavior before and 7 days after each rTMS session.

As compared to sham (mean +0.74; standard deviation ± 3.03), real rTMS significantly decreased cue-induced craving (−2.12 ± 3.39; F(1,19) = 4.87; P = 0.04; partial η2 = 0.05; 95% CI: 0.00–0.21). No significant effect of rTMS was observed on gambling behavior.

Patients with GD reported decreased cue-induced craving following a single session of high frequency rTMS applied over the left DLPFC. Further large randomized controlled studies are needed to determine the usefulness of rTMS in GD.