Davranışsal Bağımlılıklara Giriş ve Genel Bakış
Özet
Davranışsal bağımlılıklar; olumsuz sonuçlarına rağmen bir davranışı sürdürme, kontrol kaybı ve aşerme ile karakterize olup alkol ve madde bağımlılığına benzer nörobiyolojik ve psikolojik mekanizmaları paylaşmaktadır. Tarihsel süreçte DSM tanı sistemine ilk olarak "patolojik kumar oynama" ile giren bu kavram, günümüzde internet, oyun ve akıllı telefon bağımlılığı gibi birçok farklı alanı kapsayacak şekilde genişlemiştir. Nörobiyolojik olarak mezolimbik ödül sistemindeki dopamin salınımı ve prefrontal korteksin inhibitör kontrolündeki zayıflama bağımlılık sürecinde kritik roller oynarken; genetik, duygu düzenleme güçlüğü gibi psikolojik süreçler ve sosyokültürel etkenler de etiyolojide etkilidir. Tedavide bilişsel davranışçı terapiler başta olmak üzere bireysel ve grup terapileri, motivasyonel görüşmeler ve naltrekson, topiramat gibi farmakolojik ajanları içeren çok yönlü, biyopsikososyal yaklaşımlar uygulanmaktadır.
Behavioral addictions are characterized by continuing a behavior despite negative consequences, loss of control, and craving, sharing similar neurobiological and psychological mechanisms with alcohol and substance dependence. Having entered the DSM diagnostic system historically with "pathological gambling," this concept has expanded today to include many different areas such as internet, gaming, and smartphone addiction. Neurobiologically, dopamine release in the mesolimbic reward system and the weakening of the inhibitory control of the prefrontal cortex play critical roles in the addiction process, while psychological processes like genetics and emotion regulation difficulties, along with sociocultural factors, are also influential in the etiology. In treatment, multidimensional, biopsychosocial approaches are applied, including cognitive behavioral therapies, individual and group therapies, motivational interviewing, and pharmacological agents such as naltrexone and topiramate.
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