Davranışsal Bağımlılıklar ve Sirkadiyen Tercihler
Özet
Davranışsal bağımlılıkların (kumar, internet, akıllı telefon, alışveriş, gıda) klinik özelliklerini, DSM-5 tanı ölçütlerini ve sirkadiyen tercihlerle (sabahçıl/akşamcıl kronotipler) olan ilişkisini inceleyen bu çalışmada, akşamcıl kronotipe sahip bireylerin yüksek risk altında olduğu belirtilmektedir. Madde bağımlılıklarında olduğu gibi davranışsal bağımlılıklarda da sirkadiyen genlerin dopaminerjik ödül devresini etkilemesi, akşamcıl tiplerde ödül motivasyonunu değiştirmektedir. Gece geç saatlerde uyanık kalma, yüksek ekran süresi, sosyal jet lag, artan dürtüsellik, stres ve düşük uyku kalitesi gibi faktörler, bireylerin internet, sosyal medya, akıllı telefon, kompulsif satın alma ve hedonik yeme bağımlılıklarına yakalanma riskini doğrudan ya da dolaylı olarak artırmaktadır. Bu doğrultuda, sirkadiyen sistemdeki aksaklıkların bağımlılık hassasiyeti ve nüks (relaps) riskini artırdığı saptanmış olup, klasik bilişsel davranışçı tedavi tekniklerine sirkadiyen ritim stabilizasyonu ve uyku düzenlemelerinin eklenmesinin tedavi başarısını optimize edeceği vurgulanmaktadır.
Examining the clinical characteristics and DSM-5 diagnostic criteria of behavioral addictions (gambling, internet, smartphone, shopping, food) and their relationship with circadian preferences (morningness/eveningness chronotypes), this study indicates that individuals with an eveningness chronotype carry a high risk. Similar to substance use disorders, the influence of circadian genes on the dopaminergic reward circuit alters reward motivation in evening types in behavioral addictions as well. Factors such as late-night wakefulness, high screen time, social jet lag, increased impulsivity, stress, and low sleep quality directly or indirectly increase individuals' risks of developing internet, social media, smartphone, compulsive buying, and hedonic food addictions. Consequently, disruptions in the circadian system are found to elevate addiction vulnerability and relapse risk, emphasizing that integrating circadian rhythm stabilization and sleep management into classic cognitive behavioral therapy techniques will optimize treatment success.
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