Abstract

Heightened aggression is identified in several psychiatric disorders, including addiction. In this preliminary study with a relatively small number of samples, aggression in subjects diagnosed with behavioural addiction (BA) was implicitly assessed using the point subtraction aggression paradigm (PSAP) test along with measurements of oxy- and deoxyhaemoglobin dynamics in the prefrontal cortex (PFC) during the test using functional near-infrared spectroscopy. Aggression in BA patients was no higher than that of healthy control (CT) subjects in the PSAP test. Although no apparent increase or decrease in haemoglobin concentrations was observed in the PFC of either BA patients or CT subjects, abnormal correlations within the PFC network were present in BA patients. Consistent with comparable aggression between the groups, blood concentrations of the sex hormone testosterone, which has been shown to be associated with aggressiveness, was even lower in BA patients than in CT subjects. In contrast, when a set of questionnaire surveys for the assessment of aggression were administered, BA patients rated themselves as more aggressive than non-BA subjects. Collectively, these results suggest that aggression may not be heightened in BA, but BA patients may overestimate their aggressiveness, raising concerns about the use of questionnaire surveys for assessments of affective traits such as aggression in behavioural addiction.

Highlights

  • Kleptomania (KM) and paraphilia (PP), which are formally diagnosed as impulse control disorders in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) [1], have been suggested to meet the criteria of behavioural addiction (BA) and are considered interchangeable in this category of disorders [2,3,4,5]

  • The BA group consisted of hospitalized patients who were diagnosed with BA (n = 16; 39.6 ± 3.68 years old; 9 males, 7 females) with different functional nearinfrared spectroscopy (fNIRS) prefrontal cortex (PFC) activity associated with the point subtraction aggression paradigm (PSAP) test was examined with fNIRS

  • No statistically significant difference was observed in the number of reactive or proactive aggression choices between BA patients and CT subjects (Fig. 1c), the ratio of reactive to proactive aggression choices tended to be higher in BA patients than in CT subjects (t41 = 1.78, p = 0.083; Fig. 1c). These results suggest that, in contrast to previous studies reporting heightened aggression in addiction patients, aggression may be comparable between BA patients and CT subjects when aggression is implicitly assessed with the PSAP test

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Summary

Introduction

Kleptomania (KM) and paraphilia (PP), which are formally diagnosed as impulse control disorders in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) [1], have been suggested to meet the criteria of behavioural addiction (BA) and are considered interchangeable in this category of disorders [2,3,4,5]. These psychiatric conditions involve symptoms of addiction, such as repetitive and persistent engagement and loss of control over specific behaviours despite negative consequences [2,3,4,5]. The way that each of these subcategories of aggression is associated with BA has remained elusive

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