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Addiction vulnerability
Addiction vulnerability is the genetic, physiological, or psychological predisposition to engage in addictive behaviors. A vulnerability to addiction may lead to an increased risk for a substance dependence. Addictions can arise in both a chemical and a behavioral manner. A chemical addiction refers to a physical substance dependence〔(【引用サイトリンク】url=http://medicalcenter.osu.edu/patientcare/healthcare_services/mental_health/mental_health_about/substance/Pages/index.aspx )〕 where a behavioral addiction involves a psychological dependence. Genetics has been shown to account for 40-60% of a person’s likelihood to develop an addiction. Current research is now working toward establishing a comprehensive picture of the neurobiology of addiction vulnerability, including all factors at work in propensity for addiction.
==Substance Addiction==
A physical, chemical addiction refers to the repeated and uncontrollable abuse of drugs or alcohol. To be physically addicted to a substance means that the normal release of neurotransmitter has been obstructed by the presence of a chemical of abuse. The reward center of the brain gets overstimulated with the pleasurable response of drug or alcohol use and adapts to accommodate these increase levels of chemical input. This creates a neural environment for addiction development. Natural neural reuptake receptors become desensitized to the drug due to repeated exposure and have to adapt to function properly only in the presence of compounding amounts of the substance.
In discussing the potential for drug abuse, it is useful to review the criteria used to diagnosis a substance use disorder. According to the American Psychiatric Association, substance use disorder is a complex behavioral disorder characterized by compulsive drug use, the development of tolerance and withdrawal, and overall functional impairment. In the Diagnostic and Statistical Manual of Mental Disorders IV-TR (DSM-IV-TR) substance use disorder was split into two categories: abuse and dependence. To meet criteria for a substance abuse diagnosis, one or more of the following criteria had to be met: (a) recurrent failure to fulfill major role obligations; (b) recurrent use of the substance in situations in which it might be hazardous; (c) recurrent substance-related legal problems; and (d) continued substance use despite having persistent or recurrent social or interpersonal problems. A substance dependence diagnosis was met if three or more of the following criteria were fulfilled: (a) tolerance; (b) withdrawal; (c) using larger amounts or over a longer period of time than intended; (d) a persistent desire or unsuccessful efforts to cut down or control use; (e) spending a great deal of time obtaining, (f) using or recovering from the effects of the substance; (g) reducing or giving up important activities due to substance use; and (h) persistent physical or psychological problem that are likely due to or exacerbated by the substance.
With the revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) there has been a shift from the traditional categorization of addiction as substance abuse and/or dependence to a more dimensional model that combines the diagnostic criteria from both “abuse” and “dependence” into a singular disorder. The criteria for diagnosis remains relatively the same in the DSM-5 with a few changes such as the removal of “recurrent legal problems” criteria, the addition of “craving or a strong desire to use the substance,” and the threshold for diagnosis has been revised to include positive identification with two or more criteria. The shift from a categorical to a more dimensional approach exemplifies the evolving conceptualization of addiction in the field.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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