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Analytical priority, however, was given to literature reviews, and articles published via a newest to oldest methodology.

The following search terms and their derivatives were used in multiple combinations: Multiple combinations of the following search terms and their derivatives were used in conducting the research: Internet Addiction As this is another emerging topic, there was no time-scope set for this topic, although priority was given to studies and reviews published in the previous five years.

Special attention to nomenclature was required here, as the disorder is studied under different headings.

As such, the following search terms and their derivatives were used in multiple combinations: Internet Gaming Disorder No time-limitation was placed on this topic, and the following search terms and their derivatives were used in multiple combinations: A less-than-exhaustive final selection approach was taken based on the fact that the APA has already approved IGD as a research-worthy diagnosis, and thus the full volume of articles in this subject area was not needed to support our premise.

Internet Pornography Addiction Research into the area of addictive sexual behaviors on the Internet began with an inquiry into the various constructs surrounding compulsive sexual behavior.

There was no specific time-delimitation for this search, however, as with behavioral addiction, analytical priority was placed upon literature reviews and articles published via a newest to oldest methodology.

Additional screening was required to differentiate articles about IP included and non-IP not included. Multiple combinations of the following search terms and their derivatives were used: Neurobiology of Addiction All drugs of abuse affect the mesolimbic dopamine DA pathway, which originates from the ventral tegmental area VTA and projects into the nucleus accumbens NAcc. Commonly called the reward center, the NAcc is heavily connected with pleasure, reinforcement learning, reward seeking, and impulsivity.

The mesolimbic dopamine pathway connects with three other key regions to form a collection of integrated circuits commonly called the reward system: The amygdala positive and negative emotions, emotional memoryhippocampus processing and retrieval of long term memoriesand the frontal cortex coordinates and determines behavior. Taken together, the reward system and its connecting regions modulate, among other things, pleasure, reward, memory, attention, and motivation [ 43 ].

Naturally occurring behaviors such as eating and sex, have evolved such that they activate the reward system due to the fact that they reinforce behaviors necessary for survival [ 20 ].

The past decade has yielded multiple theories of addiction, all of which involve the reward system and related brain regions and substrates [ 44 ]. Three-Stage Model of Addiction Nora Volkow describes addiction as a neurobiochemically based shift from impulsive action learned through positive reinforcement to compulsive actions learned through negative reinforcement [ 43 ].

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This in turn is seen as leading to an addictive cycle that progressively worsens over time. Different classes of drugs activate the reward system through different means, however, the universal result is a flood of dopamine in the NAcc reward center.

This results in acute positive reinforcement of the behavior that initiated the flood. In this impulsive stage, this positive reinforcement results in addictive related learning associations [ 45 ]. Neuroplastic changes begin to occur, however, as the continued release of dopamine in the NAcc leads to an increase in dynorphin levels. Dynorphin, in turn, decreases the dopaminergic function of the reward system, resulting in a decrease of the reward threshold and an increase in tolerance [ 4345 ].

The resulting negative emotional state leads to activation of brain stress systems and dysregulation of anti-stress systems. This leads to a decreased sensitivity to rewards and an increase in the reward threshold, which is called tolerance.

This further progresses to negative reinforcement as the individual continues to engage in the addictive behaviors to avoid the negative affect associated with withdrawal.

A key point of this stage is that withdrawal is not about the physiological effects from a specific substance. Rather, this model measures withdrawal via a negative affect resulting from the above process. Aversive emotions such as anxiety, depression, dysphoria, and irritability are indicators of withdrawal in this model of addiction [ 4345 ].

Researchers opposed to the idea of behaviors being addictive often overlook or misunderstand this critical distinction, confusing withdrawal with detoxification [ 4647 ].

A second component of the reward system comes into play here; the mesocortical dopamine pathway. Specific affected areas within the prefrontal cortex include the dorsolateral prefrontal cortex DLPFCresponsible for key components of cognition and executive function, and the ventromedial prefrontal cortex VMPFC responsible for components of inhibition and emotional response.

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Taken together, the mesocortical dopamine pathway affects the cognitive component of reward processing [ 4345 ]. The I-RISA model integrates the increased salience of learned drug-related cues resulting from the aforementioned positive and negative reinforcement of the addictive behavior with newly developed deficiencies in top-down inhibitory control.

This leaves the individual vulnerable to reinstatement of the behavior, and two primary mechanisms have been identified; cue-induced reinstatement and stress-induced reinstatement [ 4345 ]. Anti-Reward George Koob proposed an expansion of the second stage of addiction. In the opponent-process model of motivation, a-processes reflect positive hedonic effects and b-processes reflect negative hedonic effects.

The application in addiction is that a-processes occur first and reflect tolerance. In contrast, the b-processes arise after the a-process have concluded and reflect withdrawal. Solomon and Corbit [ 52 ] used skydivers as an example of the opposite, wherein the novice skydivers experience great fear when they jump b-process and some relief when they land a-process.

As they repeat the behavior, the balance shifts such that experienced skydivers experience some fear when they jump but great relief when they land. Koob [ 51 ] overlays a detailed biologic model onto the psychological opponent-process theory. The aforementioned elevated levels of dynorphin further elevate CRF, and the engagement of these systems brings about many of the negative affects linked to the withdrawal stage. Compounding the problem, the brains anti-stress system also becomes dysregulated, as evidenced by decreases in neuropeptide Y a natural anxiolytic in the brain.

The reward system subsequently develops an altered set-point, leaving the individual vulnerable to relapse and dependence. Neurobiology of Learning, Habit, and Motivation While both the Anti-Reward and I-RISA models include learning components, other theories of addiction focus primarily on the learning aspects of addiction, and the biological underpinnings thereof.

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Everitt and Robbins [ 5556 ] propose a model of addiction as a steady transition from voluntary actions to habitual actions to compulsive actions. Their model includes a combination of classical Pavlovian stimulus-response conditioning and instrumental learning, and they presented evidence illustrating a shift in brain activity from the ventral striatum location of the NAcc to the dorsal striatum brain region established for compulsive behaviors through the course of the development of addiction.

The Incentive Salience theory follows the framework of a hypersensitized mesocorticolimbic DA pathway, however, this theory focuses on the motivational attributions attached to the behavior, rather than pleasure or reward [ 58 ]. Robinson and Berridge [ 61 ] recently updated their model to remove the necessity of the component of liking, illustrating wanting as the only component of Incentive Sensitization theory.

Genetics Genetics, as they are relevant here, can be divided into three mechanisms; Genetic heritability, addiction related genetic expression in the individual, and epigenetics intersecting the two. Volkow and Muenke [ 63 ] report common genetic factors on both sides of dual diagnoses; for example, ADHD and substance abuse. Agrawal and colleauges [ 64 ] performed a literature review and identified addiction related genes as belonging in one of two categories; genes that potentiate metabolic changes in response to specific substances, and genes that influence reward-system behaviors such as DRD2.

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These authors also found that early stages of addictive process were more tied to environmental factors, while later stages were more tied to heritability. These interruptions result in a hypodopaminergic state that yields a predisposition to addictive, compulsive, and impulsive behaviors, as well as several personality disorders.

Molecular Underpinnings of Addiction A large amount of research on the molecular explanation for addiction has emerged in the last decade, often focusing on the roles of CREB, DeltaFosB and glutamate [ 2686970717273 ]. The sum of this research indicates that the flooding of dopamine in the reward system triggers an increase in the production of cyclic AMP cAMPa small molecule that then signals the release of cAMP response element-binding protein CREB.

CREB is a protein that regulates the expression of specific genes. In this case, the result is the release of dynorphin, a protein that slows the release of dopamine and inhibits the VTA, thereby dampening the reward system. Researchers believe this to be the molecular basis of tolerance, as increased amounts of the drug or behavior are required to overcome the increased amounts of CREB. This process is also involved with dependence, as the inhibited reward system leaves the individual in a state of anhedonia when abstinent from the source of problematic dopamine release.

When the addict becomes abstinent, CREB levels quickly drop, tolerance fades, and sensitization begins. At this point, DeltaFosB becomes the predominant factor. DeltaFosB is a transcription factor that operates partially in an opposite manner to CREB, in that it suppresses dynorphin and increases sensitivity in the reward pathway. Additionally, whereas elevated CREB levels dissipate quickly, the elevated levels of DeltaFosB remain for extended periods—weeks or months.

This enhances response to rewards and reward related cues, leaving the individual sensitive to addiction related cues and vulnerable to compulsive behaviors and relapse. A third component is the neurotransmitter glutamate. Researchers are finding glutamate to be intimately involved with the learning component of addiction, and the increased amount of dopamine in the mesocorticolimbic pathway leads to an increased sensitivity to glutamate. Olsen cited fMRI studies showing gambling, shopping, sex orgasmvideo games, and the sight of appetizing food to activate the mesocorticolimbic system and extended amygdala in the same manner as do drugs of abuse.

In their review of the genetic heritability of behavioral addiction, Lobo and Kennedy [ 75 ] reported pathological gamblers to be three times more likely to have a parent who is a pathological gambler, and twelve times more likely to have grandparent. Blum has consistently included addictive behaviors in his constellation of domains impacted by RDS. In an early paper on the reward cascade, Blum et al. The following list represents specific behavioral problems currently tied to RDS please note here that we use the original terms, although we would not categorize Internet Gaming or Aberrant Sexual Behavior under the term Compulsive Behaviors: Exposure to these behaviors, just as occurs with exposure to rewarding drugs, is facilitative of the addiction process rather than causative of addiction.

The state of brain anatomy and physiology is the underlying variable that is more directly causative of addiction. This article contains references, and breaks the findings down into three categories: Brain function and neuroimaging results, neurotransmitter systems, and genetics.

Gambling, Internet, gaming, shopping, kleptomania, and sex. The left column of the table included a summary of the existing research on the specific behavioral addiction, and the right column contrasted them with corresponding findings for substance abuse. The authors concluded that there is limited but emerging data connecting different behavioral addictions with existing research on substance abuse.

Her parents divorced when she was seven years old and Kuzma moved with her mother and three sisters to her great-grandmother's house. Around that same time, her mother enrolled at Ohio University and landed a part-time job.

You know, kids at sixteen, a husband who drinks and beats you.

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When I hit L. I was hateful to my mother. If I came home from a date at I just wanted to piss my mother off. She didn't see her father for many years after. She was angry at her mother and found a father figure in her mother's boyfriend. Roger Hayes, as she calls him in her autobiographywas a drug abuser and molested Kuzma in her sleep.

Kuzma refused to follow them to a new place and was left with her older sister Lorraine. Her mother and two younger sisters eventually found a new apartment. Pornography career[ edit ] At age 13, Kuzma became pregnant by her high school boyfriend. Afraid of her mother's reaction, she went to Hayes for help. He arranged for her to have an abortion without her mother's knowledge. The woman offered to improve Kuzma's job opportunities by helping her get a fake driver's license.

She provided Kuzma with a new birth certificate on condition that if she were ever caught she would say that she had stolen the phony identification. She was now able to line up a few job interviews. Posing as her stepfather, Hayes drove her to the agency. During August, when she was selected to model for Penthouse magazine's 15th-anniversary issue, Kuzma was asked to choose a stage name. She chose Traci—one of the popular names she had longed for growing up—and Lords, after the actor Jack Lordsince she was a fan of the television series Hawaii Five-Oin which he portrayed the character of Steve McGarrett.

Some of her schoolmates recognized her in the Velvet magazine pictorial. Lords subsequently quit high school at age 15 and entered the sex industry, where formal education was irrelevant. Lords' article stated that she was 22 years of age, was a virgin until nineteen, and had studied interior design at El Camino College.

Lords made the first of her many illegal movies during Octoberwhen she appeared in What Gets Me Hot! Besides her work in porn, she also appeared in the music video for " Gimme Gimme Good Lovin' " by the heavy metal band Helix.

Lords continued making more movies until the autumn of when she tried to quit the industry at age 17 she returned a few months later.

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Afterward, she met Stuart Dell, who became her boyfriend, manager, and business partner. They formed the Traci Lords Company. Dell and Lords made a distribution deal with Sy Adler, an industry veteran who ran Vantage International, that they would produce three movies for the company. She had lied to law enforcement, photographers, producers, directors, co-workers, and the general public for two years.

The owners of her movie agency and X-Citement Video, Inc. See United States v. She was taken into protective custody and hired high-profile lawyer Leslie Abramson. On July 10, district attorney 's investigators searched Lords' Redondo Beach home as well as the Sun Valley offices of Vantage International Productions a major producer of adult movies and the Sherman Oaks offices of modeling agent Jim South. South and other industry officials said that Lords, who was seeking employment, provided a California driver's license, a U.

Leslie Jay, a spokeswoman for Penthouse publisher Bob Guccionealso said Lords showed identification indicating that she was older than 18 before the illicit photos for the September issue were taken she was actually fifteen years of age in the photographs. Two adults who knew Lords, but who requested anonymity, said they saw her picture in the adult magazine Velvet during Julyand telephoned the district attorney's office to inform authorities that she was underage, but that an investigator told them, "There isn't anything we can do about it.

John Weston, attorney of the Adult Film Association of Americasaid distributors should withdraw any movie made before Mayfeaturing Lords "in sexual conduct, no matter how briefly". The withdrawal of Lords' movies from the market cost the industry millions of dollars.

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While most of her movies were permanently removed from distribution in the United States, several were re-edited to remove Lords' scenes entirely such as Kinky Business and New Wave Hookersor in a few cases, had new footage filmed with a different actress playing her part as in Talk Dirty to Me Part III. This action resulted in claims that she herself had tipped off the authorities to gain immunity from prosecution while being the only one to profit from the movie.

Lords denies this notion in her autobiography and says she was reluctant to sell the rights, since at that time she was trying to become a mainstream actress, and wanted no older movies still available.

Lords was offered enormous sums of money to continue in porn, but she declined the requests. Transition to mainstream, Not of This Earth and Cry-Baby[ edit ] After spending several months in therapy, Lords decided to concentrate on acting. She enrolled at the Lee Strasberg Theatre and Film Institutewhere she studied method acting for three months. After leaving the school, Lords placed an advertisement in The Hollywood Reporter looking for representation.

She was contacted by Fred Westheimer and although the agency declined to officially represent her, he decided to send her out on a few auditions. As a result, she was offered a guest role in an episode of the television series Wiseguy. He immediately cast Lords into the lead role of Nadine Story, and Not of This Earth became her first mainstream film debut since her departure from the adult film industry. Although the film failed at the box office, it did well in video sales, and, based on that success, Lords was offered to appear in Wynorski's next film, The Haunting of Morella However, Lords turned down the offer due to the requirement of having a nude scene, since she was trying to establish herself as a serious actress.

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The Traci Lords Story. In December, she mass-mailed her resume to various agents and arranged a meeting with Don Gerler. Lords auditioned for the part of Breathless Mahoney in the film Dick Tracybut the role went to Madonna.

The film was a critical and commercial success, and her portrayal of the rebellious teenager Wanda Woodward established her as a legitimate actress. On the set of the film, she met the property master Brook Yeaton, whom she began dating. The couple married in September in Baltimore, Maryland.

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Directed and produced by her former boyfriend and business partner Stewart Dell, the video had been filmed in early An extended version was reissued in under the title Traci Lords: