Table 1.
Overview of possible disorder categories for “PG” and central research findings in relation to “PG”.
Impulse Control Disorders | Substance-related and Addictive Disorder | Pathological Gambling | |
---|---|---|---|
Primary diagnostic criteria | Repeated, intense urges Tension before the act and relief afterwards Preoccupation with thoughts or mental images |
A strong desire or sense of compulsion to take the drug Lack of control |
A strong desire or sense of compulsion to gamble Lack of control |
Key behavioral characteristics | Repetitive behaviors that are not pleasurable; characterized by tension beforehand and relief afterwards | Repetitive, reward-related acts that are pleasurable at the beginning | Repetitive reward-related acts that are pleasurable at the beginning |
Comorbidities | Not frequently co-occurring with “PG” | Frequently co-occurring with “PG” | Frequently co-occurring with “SADs” but not with “ICDs” |
Key brain structures | Not known for pyromania and kleptomania; likely IFC due to its role in impulse control | PFC-striatum circuitry At the beginning ventral striatum; later stages dorsal striatum |
PFC-striatum circuitry At the beginning ventral striatum; later stages dorsal striatum |
Compulsivity and/or impulsivity | Impulsivity | At the beginning impulsivity; later stages compulsivity | At the beginning impulsivity; later stages compulsivity |
Reward sensitivity | Not known; not a central aspect of the disease | Decreased sensitivity to non-drug rewards; increased sensitivity to drug rewards | Decreased sensitivity to non-drug rewards; increased sensitivity to gambling-related rewards |
Abbreviations: IFC: inferior frontal cortex; PFC: prefrontal cortex