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Background and Objectives: Impulse Control Disorders (ICDs) including pathological gambling, hypersexuality, compulsive eating, compulsive buying, and other related behaviors are well-known distinct non-motor symptoms in Parkinson's Disease (PD). Some large-scale studies present a prevalence of at least 10%, however, there are other reports providing much higher rates. The majority of the conducted studies investigating ICDs focus mainly on pharmacological factors, however, from a psychological perspective, there is yet enough room for investigation. In order to address the above issues, we designed a two-part study. Materials and Methods: First, we aimed to identify the incidence of ICD and related behaviors in a cohort of 892 Greek PD patients. Second, we administered a comprehensive battery of psychometric tools to assess psychological factors such as personality dimensions, quality of life, defenses, coherence, and resilience as well as to screen general cognitive capacity in PD patients with ICD manifestations. Results: With regard to the first part, we identified ICD manifestations in 12.4% of the patients. Preliminary findings from the second part indicate elevated activity, rather than impulsivity, as well as interrelations between several variables, including measures of activity, coping mechanisms, and quality of life. Conclusions: We present a working hypothesis for the contribution of high activity channeled to specific behavioral patterns through specific coping mechanisms, concerning the emergence of ICDs and related behaviors in PD, and further stress the importance of compulsivity rather than impulsivity in this process.

Dopamine agonist medication is one of the largest risk factors for development of problematic impulse control behaviours (ICBs) in people with Parkinson's disease. The present study investigated the potential of dopamine gene profiling and individual performance on impulse control tasks to explain ICB severity. Clinical, genetic and task performance data were entered into a mixed-effects linear regression model for people with Parkinson's disease taking (n = 50) or not taking (n = 25) dopamine agonist medication. Severity of ICBs was captured via the Questionnaire for Impulsive-compulsive disorders in Parkinson's disease Rating Scale. A cumulative dopamine genetic risk score (DGRS) was calculated for each participant from variance in five dopamine-regulating genes. Objective measures of impulsive action and impulsive choice were measured on the Anticipatory Response Inhibition Task and Balloon Analogue Risk Task, respectively. For participants on dopamine agonist medication, task performance reflecting greater impulsive choice (p = 0.014), and to a trend level greater impulsive action (p = 0.056), as well as a longer history of DA medication (p < 0.001) all predicted increased ICB severity. DGRS however, did not predict ICB severity (p = 0.708). No variables could explain ICB severity in the non-agonist group. Our task-derived measures of impulse control have the potential to predict ICB severity in people with Parkinson's and warrant further investigation to determine whether they can be used to monitor ICB changes over time. The DGRS appears better suited to predicting the incidence, rather than severity, of ICBs on agonist medication., (© 2023. The Author(s).)

Obsessive-compulsive disorder (OCD) commonly co-occurs with other psychiatric conditions. Though research is limited, there is preliminary evidence that OCD also co-occurs with compulsive sexual behavior (CSB). Yet, few studies have investigated the demographic, clinical, and psychiatric comorbidities associated with co-occurring OCD and CSB. To address this gap, the current study aimed to evaluate rates of co-occurring OCD and CSB, identify demographic and clinical factors associated with comorbid OCD and CSB, and assess associated psychiatric comorbidity. Participants (N = 950) were patients of a large multisite treatment for OCD. Standardized self-report measures were used to assess demographic and clinical characteristics such as anxiety, depression, and severity and dimensions of OCD. Semi-structured interviews including the SCID were used to assess psychiatric comorbidities. A total of 36 (3.8%) of participants met the criteria for CSB. Binary logistic regression analysis revealed that males were significantly more likely to present with CSB than females and CSB was associated with greater psychiatric comorbidity, particularly impulse control disorders. These findings suggest that individuals with co-occurring OCD and CSB may have more complex treatment needs, and more tailored interventions may be necessary., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Prior research on compulsive buying addresses a negative association with dispositional self-control and a decreasing effect of age. However, there is currently no sufficient explanation for the observation that older individuals show a reduced risk for compulsive buying patterns. Our empirical contribution is to test the assumption of a reducing effect of dispositional self-control on compulsive buying in a cross-cultural sample of Chinese (n = 268) and German (n = 247) college students with the Short Form of the Self-Control Scale and the Compulsive Buying Scale. We observed that females show a higher proneness to compulsive buying and older participants show decreased compulsive buying. Mediation analysis reveals that age has a reducing effect on compulsive buying that is fully mediated by dispositional self-control. According to the last observation, our study delivers an explanation of the reduced compulsive buying proneness of older individuals. We discuss limitations and alternative explanations of our study., (© 2022 Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive-compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity.

Objective: The aims were to explore if bulimic spectrum disorders (BSD) patients, who also present comorbid compulsive buying (CB), could represent a specific subtype considering its neuropsychological performance; to present a descriptive analysis of different clinical features; and to explore how these variables could influence treatment outcome. It was hypothesised that the comorbid group will present worse neuropsychological performance that will lead to a worse treatment outcome., Method: The study has a longitudinal design. Women (N = 75) diagnosed with BSD, BSD + CB and Healthy Controls (HC); completed an evaluation of: cognitive flexibility, decision making, eating disorder (ED) symptomatology, psychopathological state and personality traits., Results: BSD + CB was the group with the most severe clinical profile, worst treatment outcome and higher neuropsychological impairment, than other groups. Path-analysis evidenced that deficits in decision making were associated with bad treatment outcome, while deficits in flexibility with the presence of the comorbidity. Self-directedness and novelty seeking were associated with the neuropsychological performance and the comorbidity., Conclusion: BSD + CB exhibit a worse clinical and neuropsychological profile that seems to be related with the treatment outcome, which should be taken into account for the establishment of specific treatment approaches., (© 2021 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.)

Background and Aims: Impulsivity is regarded as a risk factor for sexual crime reoffending, and a suggested core feature in Compulsive Sexual Behavior Disorder. The aim of this study was to explore clinical (e.g. neurodevelopmental disorders), behavioral and neurocognitive dimensions of impulsivity in disorders of problematic sexuality, and the possible correlation between sexual compulsivity and impulsivity., Methods: Men with Compulsive Sexual Behavior Disorder (n = 20), and Pedophilic Disorder (n = 55), enrolled in two separate drug trials in a specialized Swedish sexual medicine outpatient clinic, as well as healthy male controls (n = 57) were assessed with the Hypersexual Behavior Inventory (HBI) for sexual compulsivity, and with the Barratt Impulsiveness Scale (BIS) and Connors' Continuous Performance Test-II (CPT-II) for impulsivity. Psychiatric comorbidity information was extracted from interviews and patient case files., Results: Approximately a quarter of the clinical groups had Attention-Deficit/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder. Both clinical groups reported more compulsive sexuality (r = 0.73-0.75) and attentional impulsivity (r = 0.36-0.38) than controls (P < 0.05). Based on results on univariate correlation analysis, BIS attentional score, ADHD, and Commissions T-score from CPT-II were entered in a multiple linear regression model, which accounted for 15% of the variance in HBI score (P < 0.0001). BIS attentional score was the only independent positive predictor of HBI (P = 0.001)., Discussion: Self-rated attentional impulsivity is an important associated factor of compulsive sexuality, even after controlling for ADHD. Psychiatric comorbidity and compulsive sexuality are common in Pedophilic Disorder., Conclusion: Neurodevelopmental disorders and attentional impulsivity - including suitable interventions - should be further investigated in both disorders.

Objective: Hoarding is common in obsessive-compulsive disorder (OCD), and OCD with hoarding may have poorer prognostic features than OCD without hoarding. The aim of this study was to investigate the relationship between multifaceted impulsivity and hoarding symptoms in individuals with OCD. This relationship is important to be able to understand the psychopathological mechanisms of hoarding symptoms in OCD patients., Methods: The study included 136 individuals with OCD classified as OCD with high hoarding symptoms (OCDwHH, n  = 41) and OCD with low/none hoarding symptoms (OCDwLH, n  = 95), together with 94 healthy control subjects. All the participants completed the Hoarding Rating Scale-Interview, Barratt Impulsiveness Scale-11, Yale-Brown Obsessions and Compulsions Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale., Results: The OCDwHH group had more severe anxiety ( p  = 0.016) and attentional impulsivity ( p  = 0.002) than OCDwLH. Attentional impulsivity scores were positively correlated with hoarding symptom scores ( p  < 0.001). Both attentional and motor impulsivity scores were positively correlated with anxiety levels ( p  = 0.037, p  = 0.045, respectively). In partial correlation analysis, motor impulsivity was positively correlated with the severity of hoarding symptoms controlling for anxiety severity ( p  = 0.045). In hierarchical linear regression analysis, only attentional impulsivity predicted the severity of hoarding symptoms independently of anxiety, severity of obsessive-compulsive symptoms and motor impulsivity ( β  = 0.268, Adjusted R 2 = 0.114, p  = 0.006)., Conclusion: Attentional impulsivity is associated with hoarding symptoms in OCD. Future studies that reveal this relationship may contribute to treatment modalities for the OCD patients with hoarding symptoms.

This paper analyses compulsive Internet use among Spanish adolescents as measured by the Compulsive Internet Use Scale (CIUS) of the ESTUDES 2016 survey (national survey on drug use in secondary schools), which was recently added to the statistical programme of the Spanish National Plan on Drugs. We examined two subsamples of Spanish adolescents (those who suffer from compulsive Internet use and those who do not) while taking into account gender and age. Our general hypothesis was that adolescents who suffer from compulsive Internet use have a greater prevalence of alcohol, tobacco, cannabis, sedative, and new substance consumption as well as a greater prevalence of modes of consumption such as getting drunk, drinking with friends in public places ( botellón ), and binge drinking. While our results confirm these assumptions, they also suggest that gender and age play an ambivalent role in these associations.

We reviewed studies that have specifically explored the memory deficit hypothesis of Obsessive Compulsive Disorder (OCD) checking, highlighting the methodological differences between these studies that may explain inconsistencies regarding memory deficits in OCD checkers. Based on Conway's proposition that one function of episodic memories is to keep an adaptive record of recent goal processing in order to check that actions have actually been accomplished, we suggest that impaired autonoetic consciousness -one of the main features of episodic memory- may be at the heart of the issue of checking compulsion. Autonoetic consciousness, that can be experimentally assessed by the Remember/Know/Guess paradigm,could be impaired in OCD checkers leading them to be unable to mentally relive their actions in order to be assured that they have been accomplished (e.g., having locked the door). We make methodological suggestions to improve the assessment of autonoetic consciousness deficit in OCD checkers and understand its role in the etiology and maintenance of compulsive checking.

Impulse control behaviours (ICBs) are a range of behaviours linked by their reward-based, repetitive natures. They can be precipitated in Parkinson's disease (PD) by dopamine replacement therapy, often with detrimental consequences for patients and caregivers. While now a well-recognised non-motor feature of treated PD, much remains unknown about the influence of risk factors, pathophysiological mechanisms, vulnerability factors for specific types of behaviour and the optimal management strategies. Imaging studies have identified structural and functional changes in striatal and prefrontal brain regions, among others. Gene association studies indicate a role for genetic predisposition to PD-ICB. Clinical observational studies have identified potential modifiable and non-modifiable risk factors. Psychological studies shed light on the neurocognitive domains implicated in PD-ICBs and identify psychosocial determinants that may perpetuate the cycle of impulsive and harm-avoidance behaviours. Based on these results, a range of pharmacological and non-pharmacological management strategies have been trialled in PD-ICBs with varying success. The purpose of this review is to update clinicians on the evidence around the pathophysiology of PD-ICB. We aim to translate our findings into an interpretable biopsychosocial model that can be applied to the clinical assessment and management of individual cases of PD-ICB., Competing Interests: Competing interests: MJK received a honorarium for a lecture delivered to the Parkinson Voice Project non‐profit organisation, Dallas, Texas, USA, on 'Impulsivity and Creativity in Parkinson's' in October 2018. MT-MH receives funding from the Parkinson’s UK Monument Discovery Award, Oxford Biomedical Research Centre, University of Oxford, National Institute for Health Research, Michael J Fox Foundation, H2020 European Union, GE Healthcare and the PSP Association. She is on the consultancy advisory board for Biogen and Roche Pharmaceutical companies and is a consultant for CuraSen Therapeutics., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Research in adults demonstrates a positive association among obsessive-compulsive symptoms, eating pathology, cognitive distortions, and comorbid depressive symptoms. Given that adolescence is characterized by unique and rapid changes in biopsychosocial processes, it is imperative to elucidate the relationship between these variables in youth. In this cross-sectional study, we explored whether obsessive-compulsive symptoms, thought-action fusion, thought-shape fusion, and eating pathology would be positively associated with and predict depressive symptoms in a school-based community sample of adolescents ( n  = 86; M age  = 15.60). All study variables were positively correlated with depressive symptoms. Results indicated that obsessive-compulsive symptoms, thought-shape fusion, and eating pathology explained a significant proportion of variance in depressive symptoms, whereas thought-action fusion did not. In accordance with the cognitive behavioral model of psychopathology, these findings highlight the relationships between key interrelated correlates of depressive symptoms that may be pertinent targets for prevention and treatment efforts in adolescents.

Objectives: To highlight a severe case of rhinotillexomania (compulsive nasal picking) and its potential to manifest as empty nose syndrome (ENS)., Methods: A single case report with the presentation and management of a patient with severe rhinotillexomania who presented with chronic obstructive symptoms. We review the current literature on rhinotillexomania and ENS., Results: This patient's manifestations mimic the obstructive symptoms of ENS, despite widely patent nasal passages., Conclusion: This is the first report of rhinotillexomania manifesting with features of ENS.

The abuse of stimulants, such as methamphetamine (METH), is associated with treatment non-compliance, a greater risk of viral transmission, and the more rapid clinical progression of immunological and central nervous system human immunodeficiency virus (HIV) disease. The behavioral effects of METH in the setting of HIV remain largely uncharacterized. We used a state-of-the-art paradigm of the escalation of voluntary intravenous drug self-administration in HIV transgenic (Tg) and wildtype rats. The rats were first allowed to self-administer METH under short-access (ShA) conditions, which is characterized by a nondependent and more "recreational" pattern of METH use, and then allowed to self-administer METH under long-access (LgA) conditions, which leads to compulsive (dependent) METH intake. HIV Tg and wildtype rats self-administered equal amounts of METH under ShA conditions. HIV Tg rats self-administered METH under LgA conditions following a 4-week enforced abstinence period to model the intermittent pattern of stimulant abuse in humans. These HIV Tg rats developed greater motivation to self-administer METH and self-administered larger amounts of METH. Impairments in function of the medial prefrontal cortex (mPFC) contribute to compulsive drug and alcohol intake. Gene expression profiling of the mPFC in HIV Tg rats with a history of escalated METH self-administration under LgA conditions showed transcriptional evidence of increased inflammation, greater neural injury, and impaired aerobic glucose metabolism than wildtype rats that self-administered METH under LgA conditions. The detrimental effects of the interaction between neuroHIV and escalated METH intake on the mPFC are likely key factors in the greater vulnerability to excessive drug intake in the setting of HIV., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Previous studies suggest elevated prevalence rates of skin picking and self-harm in patients with obesity compared to individuals in the general population. Hence, further studies should investigate prevalence rates and correlates of skin picking in this population - especially its differentiation to self-harm. Skin picking and obesity are both associated with specific facets of impulsiveness. This relation should be explored to shed light on potentially shared mechanisms in etiology. Therefore, the present study examined the occurrence of skin picking and its associations with impulsiveness and self-harm in a sample of pre-bariatric surgery patients with obesity class II/III. Within the routine preoperative psychiatric evaluation, a total of 139 bariatric surgery candidates (78% female, BMI range 35-69) completed a self-report questionnaire assessing sociodemographic variables, anxiety, depression, self-harm, impulsiveness, and skin picking severity (urges: frequency, intensity, controllability; behavior: frequency, intensity, controllability; resistance, emotional distress, impairment, and avoidance). Ten participants (7.2% of the sample) reported recurrent skin picking leading to skin damage, repeated attempts to decrease skin picking, and psychosocial impairment (emotional distress, impairment in functional areas, avoidance) due to skin picking. In line with previous findings, skin picking severity shows a medium correlation with attentional impulsiveness. The majority of self-harm types were not associated with skin picking severity. The current study reveals a high occurrence of skin picking compared to the general population. The results indicate an association between skin picking severity and attentional impulsiveness. Further research is needed to investigate the differentiation of skin picking and self-harm in more detail., (© 2019 Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

Impulse control disorders (ICDs) and related impulsive and compulsive behaviors (together called ICBs) have been increasingly recognized in the context of Parkinson's disease (PD) and treatment. The International Parkinson's and Movement Disorder Society commissioned a task force to assess available clinical screening instruments and rating scales, including their clinimetric properties, make recommendations regarding their utility, and suggest future directions in scale development and validation. The literature was systematically searched for scales measuring a range of reported ICBs in PD. A scale was designated "recommended" if the scale had been employed in PD studies, been used beyond the group that developed it, and had adequate clinimetric data published for PD. Numerous diagnostic screening tools and severity rating scales were identified for a range of ICBs, including compulsive medication use, punding/hobbyism, walkabout, pathological gambling, hypersexuality, compulsive or binge eating, compulsive buying, reckless driving, compulsive exercise, pyromania, trichotillomania, hoarding, kleptomania, intermittent explosive disorder, and internet addiction. For screening across the range of ICBs (except compulsive medication use), the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP) and QUIP-Rating Scale (QUIP-RS) are recommended, and for severity rating across the range of ICBs the QUIP-RS and the Ardouin Scale of Behavior in Parkinson's Disease are recommended. The Scale for Outcomes in Parkinson's Disease-Psychiatric Complications is recommended for rating of hypersexuality and the compulsive behaviors gambling/shopping. Further testing of established scales against gold standard diagnostic criteria is urgently required for all other individual ICBs in PD. © 2019 International Parkinson and Movement Disorder Society © 2019 International Parkinson and Movement Disorder Society., (© 2019 International Parkinson and Movement Disorder Society.)

Purpose: Eating disorders are common in Parkinson's disease (PD) patients and often class in Impulse control disorders, however, little is known about their phenomenology. Specific symptoms and comorbidities were described in a group of PD patients in this preliminary study., Methods: Over a period of 6 months, 51 PD patients who experienced significant changes in eating habits following diagnosis of PD and were interviewed during regularly scheduled follow-up visits. We assessed each patient's height and weight, impulsivity, psychological distress, current eating disorder symptoms, food addiction, food habits and craving., Results: Among the PD patients who experienced modified dietary habits following diagnosis, few exhibited binge eating disorders (BED) full criteria (3.9%). However, 21.6% of patients experienced episodes of out-of-control eating with a large quantity of food in short time and 39.2% satisfied food addiction (FA) criteria without binge eating disorder. Food cravings more than once a week were experienced in approximately half of the population including all FA patients. Regarding comorbidities, FA PD patients present impulsive features and anxiety., Conclusions: This study confirms the existence of FA profile in PD patients. Eating disorders even in PD are complex and have a cross-cutting criteria related to out-of-control eating, FA, and BED. The association of anxiety with PD-related food addiction, contrary to L-dopa equivalent daily dose mean score or the presence of dopamine agonists, underline the complex sustainability of the dopaminergic brainstem support. A study on their detailed prevalence in this population could be helpful to better understand unspecified feeding or eating disorder., Clinical Trial Number: DR-2012-007., Name of the Registry: French Committee for the Protection of Persons (CPP) & French National Commission on Computing and Liberty (CNIL)., Level of Evidence: Level V, descriptive study.

Objective: Untreated compulsive sexual behaviour (CSB) poses a risk to efficacious substance use disorder (SUD) treatment. Yet the ways in which CSB manifests in women with SUDs remains poorly understood. Shame and trauma exposure are well-documented correlates for women's CSB. Prior theory suggested women with shame and trauma-related symptoms may engage in CSB in an effort to escape aversive internal experiences. Thus, the present study examined experiential avoidance as a mediator of the relationship between defectiveness/shame beliefs, post-traumatic stress disorder symptoms, and CSB in a sample of women with SUDs., Method: Cross-sectional, self-report data were collected from 446 women (M age = 37.40) in residential treatment for SUDs., Results: Experiential avoidance partially mediated the relationship between both post-traumatic stress disorder symptoms and defectiveness/shame beliefs and CSB., Conclusions: These results extend theoretical conceptualizations of women's CSB to a treatment population. CSB intervention efforts may benefit from targeting women's avoidance of painful experiences., (© 2018 John Wiley & Sons, Ltd.)

Impulsive-compulsive behavior (ICB) in Parkinson's disease (PD) suggests a combination of impulse control disorders (ICDs), such as pathological gambling, hypersexuality, compulsive eating, excessive buying, and compulsive behaviors, such as punding, dopamine dysregulation syndrome (DDS), hoarding, and hobbyism. Hypersexuality and gambling are common in male patients while compulsive buying is common in women patients. Recent studies reveal the prevalence of ICB to be more than 25% among the PD patients. The nigrostriatal, mesocortical, and mesolimbic dopaminergic pathways play a crucial role in the pathogenesis of ICDs in PD patients. The greater tonic release of dopamine creates a state of relative dopamine deficit and reduced reward sensation and impulsive behaviors. The major risk factors for ICB are the use of dopamine agonist (DA), male gender, young patient, depression, smoking, drug abuse, Parkin mutation, and family history of ICDs. Single nucleotide polymorphism in dopamine receptors D1, D2, and D3 also acts as a major risk factor. Questionnaire for impulsive-compulsive disorders in PD is the most widely adopted screening tool for the detection of ICB in PD. The major treatment for PD is to discontinue DAs and use prolonged release formulation of the DAs. The role of deep brain stimulation (DBS) and apomorphine in the treatment of ICB is still uncertain. Though DBS can reduce the risk of DDS, it can precipitate new ICBs such as hypersexuality., Competing Interests: There are no conflicts of interest

Background and aims Problematic Internet use (PIU) is commonplace but is not yet recognized as a formal mental disorder. Excessive Internet use could result from other conditions such as gambling disorder. The aim of the study was to assess the impact of impulsive-compulsive comorbidities on the presentation of PIU, defined using Young's Diagnostic Questionnaire. Methods A total of 123 adults aged 18-29 years were recruited using media advertisements, and attended the research center for a detailed psychiatric assessment, including interviews, completion of questionnaires, and neuropsychological testing. Participants were classified into three groups: PIU with no comorbid impulsive/compulsive disorders (n = 18), PIU with one or more comorbid impulsive/compulsive disorders (n = 37), and healthy controls who did not have any mental health diagnoses (n = 67). Differences between the three groups were characterized in terms of demographic, clinical, and cognitive variables. Effect sizes for overall effects of group were also reported. Results The three groups did not significantly differ on age, gender, levels of education, nicotine consumption, or alcohol use (small effect sizes). Quality of life was significantly impaired in PIU irrespective of whether or not individuals had comorbid impulsive/compulsive disorders (large effect size). However, impaired response inhibition and decision-making were only identified in PIU with impulsive/compulsive comorbidities (medium effect sizes). Discussion and conclusions Most people with PIU will have one or more other impulsive/compulsive disorders, but PIU can occur without such comorbidities and still present with impaired quality of life. Response inhibition and decision-making appear to be disproportionately impacted in the case of PIU comorbid with other impulsive/compulsive conditions, which may account for some of the inconsistencies in the existing literature. Large scale international collaborations are required to validate PIU and further assess its clinical, cognitive, and biological sequelae.

Objective: To determine clinical and structural imaging predictors of impulsive-compulsive behaviour (ICB) in de novo Parkinson's disease (PD)., Methods: From a cohort of 1116 subjects from the Parkinson's Progression Marker Initiative database, we created a subcohort of 42 de novo PD without ICB at baseline with available 3T MRI and who developed ICB during follow-up. PD-ICB were matched for age, gender and disease duration to 42 patients with PD without ICB over follow-up (PD-no-ICB) and 42 healthy controls (HCs). Baseline demographic and clinical predictors of ICB were analysed. For the longitudinal neuroimaging analysis, we selected 27 patients with PD-ICB with available neuroimaging after ICB onset, who were matched with 32 PD-no-ICB and 35 HCs. Baseline and longitudinal structural differences were compared using voxel-based morphometry and voxel-based quantification., Results: People who went on to develop ICB had more severe anxiety, worse autonomic and global cognitive functions and were more likely to have rapid eye movement sleep behaviour disorder. Logistic regression confirmed that worse autonomic and cognitive functions were predictors of ICB. We could not find any morphological feature on baseline MRI that predicted later onset of ICB. When comparing PD groups at follow-up, a small region of increased atrophy in the anterior limb of the left internal capsule adjacent to the head of the left caudate nucleus was found in PD-ICB, but not surviving correction for multiple comparisons., Conclusions: Worse autonomic and cognitive functions predict development of ICB at the time of PD diagnosis. Structural imaging fails to identify morphological features associated with the development of ICB., Competing Interests: Competing interests: LR has received honoraria for speaking from UCB Pharma and Chiesi Farmaceutici. CL receives royalties from publication of the Oxford Handbook of Neurology (2nd Edition, Oxford University Press, 2014). RDM does not have anything to disclose. FM receives royalties from publication of Disorders of Movement (Springer, 2016). She was part of advisory boards of Medtronic and UCB Pharma. She has received honoraria for speaking from UCB Pharma, Medtronic, Chiesi Farmaceutici, Abbvie, Allergan, Merz and Zambon. ME receives royalties from publication of Oxford Specialist Handbook of Parkinson’s Disease and Other Movement Disorders (Oxford University Press, 2008) and receives research support from a National Institute for Health Research grant where he is the principal investigator. He has received honoraria for speaking from UCB., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Objectives: The conducted studies were aimed at making a Polish adaptation of the Penn Alcohol Craving Scale (PACS) by B. Flannery and co-workers. The Scale is a self-assessment method, it comprises 5 statements, and is designed to assess alcohol craving experienced by a patient in a week prior to the examination., Methods: 550 patients with diagnosed alcohol dependence syndrome were examined, and the final analysis included results of 510 persons. The examined group consisted of 396 men and 114 women. The study was made in the 3rd week of their alcohol treatment. There were used: the PENN Craving Scale, the Alcohol Dependence Development Scale (SRUA) (the part in which craving is dealt with), a clinical interview with specially prepared questions about alcohol craving experienced last month and last week, and the Yale-Brown Obsessive Compulsive Intense Drinking Scale., Results: The Polish version of the Penn Scale is characterised by very good psychometric properties - it is a reliable and valid tool. The exploratory and confirmatory factor analyses have proved the existence of one factor. The internal consistency, assessed on the basis of Cronbach's alpha, equalled 0.89. The method displays statistically significant (majority p < 0.0010) relationships with levels of craving experienced last year, last month, and last week before the examination, and also with total score on the Yale-Brown Scale., Conclusions: The effects of the conducted adaptation works on the Penn Scale speak for recommending the method for scientific research and use in therapeutic practice.

Obsessive-compulsive disorder (OCD) is frequently associated with mood disorders. However, to date, the co-occurrence of OCD with seasonal affective disorder (SAD) has not been investigated. We have aimed to estimate the prevalence of seasonal mood changes in patients with OCD and explore the contribution of seasonality in mood to the severity of OCD. The Seasonal Pattern Assessment Questionnaire (SPAQ), the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), the Hamilton Depression Rating Scale-17 Items (HDRS-17), and the Beck Anxiety Inventory (BAI) were administered to patients with OCD (n=104) and controls (n=125). The degree of seasonality was measured by the Global Seasonality Score (GSS) calculated from the SPAQ. SAD and subsyndromal seasonal affective disorder (S-SAD) were significantly more prevalent in patients with OCD (53%, n=55) than controls (25%, n=31). When patients were assessed in the season in which SAD occurs, depression and compulsions (but not obsessions, OCD or anxiety) were more severe than those assessed in a season during which SAD does not occur. SAD frequently co-occurs with OCD and, given this co-occurrence, depression symptoms in some patients with OCD might be expected to vary on a seasonal basis., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Nearly one-third of individuals in treatment for substance use disorders endorse at-risk levels of compulsive sexual behaviours (CSBs). Untreated sexual compulsivity may facilitate relapse for treatment-seeking men. Previous research and theory suggest that CSBs are maintained by efforts to escape or alter negative affect (e.g., depression and anxiety). However, this hypothesis has not been examined within a sample of men in treatment for substance use disorders. In an effort to better understand CSBs within a population of men with substance use disorders, the present study is the first to examine experiential avoidance as one potential mechanism underlying the relation between men's symptoms of depression and anxiety and their use of CSBs. The present study reviewed medical records of 150 men in residential treatment for substance use disorders. Structural equation modelling was used to examine pathways from men's depression and anxiety symptoms to CSBs directly and indirectly through experiential avoidance while controlling for alcohol/drug problems and use. Results revealed significant indirect effects of both depression and anxiety symptoms on CSB through experiential avoidance. These results support and extend existing research on CSB in a treatment population. Findings suggest that intervention efforts for CSB may benefit by targeting men's avoidance of painful internal events., Key Practitioner Message: Compulsive sexual behaviour is related to symptoms of depression and anxiety amongst men in residential treatment for substance use disorders. Experiential avoidance is positively related to compulsive sexual behaviour amongst men with substance use disorders. For men in treatment for substance use disorders, the relation between symptoms of depression and anxiety and compulsive sexual behaviour is explained, in part, by experiential avoidance. Helping men with substance use disorders develop more adaptive methods of processing aversive experiences, as opposed to escaping them, may reduce their use of compulsive sexual behaviours when faced with aversive affect., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Compulsive buying disorder (CBD) is a condition characterized by excessive preoccupations, impulses, and behaviors regarding buying, resulting in serious psychological, social, and financial problems. Even though it has not been included in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, "behavioral addictions" section, CBD is a hot topic in current clinical psychiatry, because of its relevant prevalence (at least 5% in adult populations) and severe effect on quality of life.The CBD shares some clinical features with substance-related and behavioral addictions, impulse control disorders, and obsessive compulsive disorder, and it is often comorbid with other psychiatric illnesses (especially depressive and anxiety disorders). The treatment of CBD is therefore difficult, and clear therapeutic guidelines are not yet available. Treating the comorbid disorders as the first-line approach, or combining drugs with different pharmacodynamic profiles, has been suggested to address this challenging condition., Case: A 60-year-old woman affected by a severe form of CBD with comorbid major depressive disorder, resistant/intolerant to previous selective serotonin reuptake inhibitor treatments and only partially responder to mirtazapine, achieved a good clinical improvement adding bupropion., Conclusions: Combining 2 agents with different pharmacological profiles and mechanisms of action, such as bupropion and mirtazapine, could be a useful strategy in the management of complex CBD cases.

The occurrence of repetitive behaviours that are often harmful has been attributed to traits traditionally described as "impulsive" or "compulsive" e.g. substance dependence, excessive gambling, and hoarding. These behaviours are common and often co-occur in both the general population and psychiatric populations. The lack of measures to concurrently index a range of such behaviours led to the development of the Impulsive-Compulsive Behaviours (ICB) Checklist. This study aims to validate the ICB Checklist in a general community sample. Factor analyses revealed a two-factor structure, demonstrating good model fit in two independent samples. These were labelled Impulsive-Compulsions and Compulsive-Impulsions, comprising of classically compulsive and impulsive behaviours respectively. Reliability and construct validity were further confirmed using correlations with existing measures of impulsivity and compulsivity. Results suggest that the ICB Checklist is a valid and practical assessment that can be used to monitor behavioural clusters characterised by deficits in inhibition., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

We examined the association between kleptomania and addictive disorders, including behavioral addictions. Fifty-three individuals with a diagnosis of kleptomania completed measures of kleptomania severity, semi-structured clinical interviews to assess co-morbid diagnosis of addictive disorders, and the Shorter PROMIS Questionnaire (SPQ) assessing an array of addictive behaviors. 20.75% of the sample met criteria for an addictive disorder; four for a substance use disorder and four for a behavioral addiction. Kleptomania severity was significantly associated with compulsive work and shopping measured by the SPQ. The results suggest the need to assess a wide array of addictive behaviors in individuals with kleptomania., (Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.)

The mechanisms underlying social dysfunction in neuropsychiatric conditions such as obsessive-compulsive disorder and Tourette syndrome remain uncertain. However, it is known that dysfunctions in basal ganglia, including a reduced number of striatal cholinergic interneurons (SCIN), are involved in their pathophysiology. To explore the role of SCIN in relation to perseverative behaviors, we characterized a new transgenic mouse model in which inducible ablation of SCIN is achieved with high efficiency in a cell-type- and region-specific manner. Mice were subjected to extensive behavioral testing, including assessment of social behaviors, and corticostriatal functional connectivity was evaluated in vivo Selective SCIN ablation leads to altered social interactions together with exacerbated spontaneously emitted repetitive behaviors. Lesioned mice showed normal motor coordination, balance, and general locomotion. Interestingly, only environmentally driven, but not self-directed, repetitive behaviors were exacerbated in lesioned mice. Remarkably, in mice with SCIN ablation, the normal pattern of social exploration was replayed continuously. The emerging pattern of social interactions is highly predictable and invariant across time. In vivo electrophysiological recordings indicate that SCIN ablation results in an increase of the functional connectivity between different cortical areas and the motor, but not associative, region of the striatum. Our results identify a role of SCIN in suppressing perseverative behaviors, including socially related ones. In sum, SCIN ablation in mice leads to exacerbated ritualistic-like behaviors that affect social performance, providing a link between SCIN dysfunction and the social impairments present in psychiatric disorders. SIGNIFICANCE STATEMENT We sought to uncover the impact of striatal cholinergic interneuron (SCIN) degeneration on perseverative behaviors related to obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). We found that extensive SCIN ablation results in exacerbated social interactions, in which normal social contacts were replayed continuously in a highly stereotyped, ritualistic pattern. SCIN ablation also leads to an increase in other spontaneously emitted repetitive behaviors without alteration of motor coordination, balance, or locomotion. Moreover, we identify an increase of functional connectivity between frontal cortical areas and the motor region of the striatum as a putative substrate for the observed behavioral alterations. Therefore, perseveration induced by SCIN ablation extends to social performance as occurs in neuropsychiatric conditions such as OCD and TS., (Copyright © 2017 the authors 0270-6474/17/372849-10$15.00/0.)

Introduction: Hypersexuality has been conceptualized as sexual addiction, compulsivity, and impulsivity, among others, in the absence of strong empirical data in support of any specific conceptualization., Aim: To investigate personality factors and behavioral mechanisms that are relevant to hypersexuality in men who have sex with men., Methods: A sample of 242 men who have sex with men was recruited from various sites in a moderate-size mid-western city. Participants were assigned to a hypersexuality group or a control group using an interview similar to the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. Self-report inventories were administered that measured the broad personality constructs of positive emotionality, negative emotionality, and constraint and more narrow constructs related to sexual behavioral control, behavioral activation, behavioral inhibition, sexual excitation, sexual inhibition, impulsivity, attention-deficit/hyperactivity disorder, and sexual behavior., Main Outcome Measures: Hierarchical logistic regression was used to determine the relation between these personality and behavioral variables and group membership., Results: A hierarchical logistic regression controlling for age showed a significant positive relation between hypersexuality and negative emotionality and a negative relation with constraint. None of the behavioral mechanism variables entered this equation. However, a hierarchical multiple regression analysis predicting sexual behavioral control indicated that lack of such control was positively related to sexual excitation and sexual inhibition owing to the threat of performance failure and negatively related to sexual inhibition owing to the threat of performance consequences and general behavioral inhibition, Conclusion: Hypersexuality was found to be related to two broad personality factors that are characterized by emotional reactivity, risk taking, and impulsivity. The associated lack of sexual behavior control is influenced by sexual excitatory and inhibitory mechanisms, but not by general behavioral activation and inhibitory mechanisms., (Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Pathological doubting and checking is a common symptom presentation in obsessive-compulsive disorder (OCD). Previous research has established that compulsive checkers do not display an actual memory deficit, but lack confidence in their memories and experience intolerance of uncertainty regarding the completion of tasks. We investigated whether interpretive cognitive bias modification (CBM-I) reduced memory distrust and intolerance of uncertainty in a nonclinical sample. We also examined the possible enhancement of CBM-I for OCD through imagery training. The results provide evidence that participants who received positive imagery CBM-I training may have interpreted novel ambiguous checking scenarios more adaptively and endorsed negative checking beliefs less relative to participants in the control imagery CBM-I condition. Findings on behavioural checking tasks did not indicate any specific response to CBM-I training. Future research may translate these suggestive findings into a useful adjunct to traditional strategies targeting maladaptive OCD beliefs., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Previous research has found a higher lifetime prevalence of eating disorders in women undergoing fertility treatment., Aims: This study aimed to gauge the prevalence of eating disorders in women attending a fertility clinic and to compare current disordered eating attitudes and exercise amongst different infertility categories., Materials and Methods: Three hundred and eighty-five women were grouped according to infertility diagnosis: male factor, unexplained infertility, ovulatory disorders, polycystic ovarian syndrome (PCOS) and heterogeneous causations. Participants anonymously completed the Eating Disorder Examination Questionnaire (EDE-Q), the International Physical Activity Questionnaire (IPAQ) and a Demographics questionnaire., Results: The lifetime history of self-reported eating disorders for women in the sample was similar to Australian community rates. Profile analysis revealed on the EDE-Q that women with ovulatory disorders were not significantly different from women with PCOS; however, they were significantly different to women with other infertility diagnoses (all P < 0.05), suggesting increased vulnerability to disordered eating. There were no between-group differences in exercise quantity (IPAQ, P = 0.625) although women with ovulatory disorders and PCOS had a significantly higher risk of engaging in compulsive, 'driven' exercise (OR = 6.98, CI = 1.39, 34.90, P = 0.018) as a means to control weight or shape., Conclusions: Contrary to previous research, our findings do not confirm a greater lifetime prevalence rate of eating disorders in women attending an infertility clinic. This study does highlight the importance of screening women with forms of an ovulatory disorder for features of disordered eating attitudes and driven exercise behaviours., (© 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

Introduction: Chorea is well described in a group of patients with Systemic Lupus Erythematosus (SLE). There is less information, however, on other movement disorders as well as non-motor neuropsychiatric features such as obsessive-compulsive symptoms (OCS), executive dysfunction and attention deficit and hyperactivity disorder (ADHD) in subjects with SLE., Methods: Fifty-four subjects with SLE underwent a battery of neuropsychiatric tests that included the Mini Mental State Examination, the Montreal Cognitive Assessment, the Frontal Assessment Battery (FAB), the FAS verbal and the categorical (animals) semantic fluency tests, the Obsessive and Compulsive Inventory - Revised, the Yale-Brown Obsessive and Compulsive Scale and Beck's Anxiety and Depression Scales. ADHD was diagnosed according to DSM-IV criteria. SLE disease activity and cumulative damage were evaluated according to the modified SLE Disease Activity Index 2000 (mSLEDAI-2K) and the SLICC/ACR, respectively., Results: Six (11.1%) and 33 (61.1%) patients had cognitive impairment according to the MMSE and MoCA, respectively. Eleven (20.4%) had abnormal FAB scores, and 5 (9.3%) had lower semantic fluency scores than expected. The overall frequency of cognitive dysfunction was 72.2% (39 patients) and of neuropsychiatric SLE was 77.8% (42 patients). Two patients (3.7%) had movement disorders. Fifteen (27.8%) had OCS and 17 (31.5%) met diagnostic criteria for ADHD. ADHD and OCS correlated with higher disease activity, p=0.003 and 0.006, respectively. Higher cumulative damage correlated with lower FAB scores (p 0.026)., Conclusions: Executive dysfunction, ADHD, OCS, and movement disorders are common in SLE. Our finding suggests that there is frequent basal ganglia dysfunction in SLE., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Although electronic technology currently plays an integral role for most youth, there are growing concerns of its excessive and compulsive use. This study documents patterns and impact of electronics use in individuals with autism spectrum disorder compared to typically developing peers. Participants included 172 parents of typically developing individuals and 139 parents of individuals with an autism spectrum disorder diagnosis, ranging in age from 6 to 21 years. Parents completed an online survey of demographics and the frequency, duration, and problematic patterns of electronics use in their youth and young adults. Individuals with autism spectrum disorder were reported to use certain electronics more often in the last month and on an average day, and had greater compulsive Internet and video game use than individuals without autism spectrum disorder. Across both samples, males used video games more often than females. Compared to parents of individuals without autism spectrum disorder, parents of individuals with autism spectrum disorder were significantly more likely to report that electronics use was currently having a negative impact. The implications of problematic electronics use for individuals with autism spectrum disorder are discussed., (© The Author(s) 2015.)

Repeated checking leads to reductions in meta-memory (i.e., memory confidence, vividness and detail), and automatization of checking behavior (Dek, van den Hout, Giele, & Engelhard, 2014, 2015). Dek et al. (2014) suggested that this is caused by increased familiarity with the checked stimuli. They predicted that defamiliarization of checking by modifying the perceptual characteristics of stimuli would cause de-automatization and attenuate the negative meta-memory effects of re-checking. However, their results were inconclusive. The present study investigated whether repeated checking leads to automatization of checking behavior, and if defamiliarization indeed leads to de-automatization and attenuation of meta-memory effects in patients with OCD and healthy controls. Participants performed a checking task, in which they activated, deactivated and checked threat-irrelevant stimuli. During a pre- and post-test checking trial, check duration was recorded and a reaction time task was simultaneously administered as dual-task to assess automatization. After the pre- and post-test checking trial, meta-memory was rated. Results showed that relevant checking led to automatization of checking behavior on the RT measure, and negative meta-memory effects for patients and controls. Defamiliarization led to de-automatization measured with the RT task, but did not attenuate the negative meta-memory effects of repeated checking. Clinical implications are discussed., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Syndrome specific repetitive behavior profiles have been described previously. A detailed profile is absent for Rubinstein-Taybi syndrome (RTS). The Repetitive Behaviour Questionnaire and Social Communication Questionnaire were completed for children and adults with RTS (N = 87), Fragile-X (N = 196) and Down (N = 132) syndromes, and individuals reaching cut-off for autism spectrum disorder (N = 228). Total and matched group analyses were conducted. A phenotypic profile of repetitive behavior was found in RTS. The majority of behaviors in RTS were not associated with social-communication deficits or degree of disability. Repetitive behavior should be studied at a fine-grained level. A dissociation of the triad of impairments might be evident in RTS.

Hierarchical cluster analyses were used to detect three subgroups in a sample of children with pervasive developmental disorder--not otherwise specified (PDD-NOS) evaluated at ages 2 and 4. At age 2, Cluster 1 demonstrated few autism symptoms and high cognitive scores; 60% no longer met criteria for PDD at 4. Cluster 2 exhibited more autism symptoms and lower cognitive scores at 2; 89.5% met criteria for ASD at 4. Cluster 3 had the lowest cognitive scores and most impaired social/communication skills at 2, but no repetitive behaviors; 60% diagnosed with Autistic Disorder at 4. Results shed light on outcomes for different PDD-NOS types and raise questions regarding the increased importance of repetitive behaviors in DSM-5.

The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) to classify children with ASD, (2) examine psychometric properties of different ASD classification methods, including the SEED method that incorporates rules for resolving ADI-R and ADOS discordance, and (3) determine whether restricted interests and repetitive behaviors were noted for children who had instrument discordance resolved using ADI-R social and communication scores. Results support the utility of SEED criteria when well-defined groups of children are an important clinical or research outcome.

Alcohol and nicotine are the two most co-abused drugs in the world. Previous studies have shown that nicotine can increase alcohol drinking in nondependent rats, yet it is unknown whether nicotine facilitates the transition to alcohol dependence. We tested the hypothesis that chronic nicotine will speed up the escalation of alcohol drinking in rats and that this effect will be accompanied by activation of sparsely distributed neurons (neuronal ensembles) throughout the brain that are specifically recruited by the combination of nicotine and alcohol. Rats were trained to respond for alcohol and made dependent using chronic, intermittent exposure to alcohol vapor, while receiving daily nicotine (0.8 mg/kg) injections. Identification of neuronal ensembles was performed after the last operant session, using immunohistochemistry. Nicotine produced an early escalation of alcohol drinking associated with compulsive alcohol drinking in dependent, but not in nondependent rats (air exposed), as measured by increased progressive-ratio responding and increased responding despite adverse consequences. The combination of nicotine and alcohol produced the recruitment of discrete and phenotype-specific neuronal ensembles (∼4-13% of total neuronal population) in the nucleus accumbens core, dorsomedial prefrontal cortex, central nucleus of the amygdala, bed nucleus of stria terminalis, and posterior ventral tegmental area. Blockade of nicotinic receptors using mecamylamine (1 mg/kg) prevented both the behavioral and neuronal effects of nicotine in dependent rats. These results demonstrate that nicotine and activation of nicotinic receptors are critical factors in the development of alcohol dependence through the dysregulation of a set of interconnected neuronal ensembles throughout the brain., (Copyright © 2015 the authors 0270-6474/15/356241-13$15.00/0.)

Background: Previous research demonstrated a close relationship between hoarding disorder (compulsive hoarding, CH) and compulsive buying (CB). Hoarding disorder was included in the 5th version of the Diagnostic and Statistical Manual of Mental Disorders (APA, 2013) with excessive acquisition as a specifier. This pilot study aimed to investigate whether individuals with both hoarding and buying symptoms (CBCH group) will present with the highest severity levels of hoarding as well as buying psychopathology compared to the respective group exhibiting only one syndrome (CH group: only hoarding, CB group: only buying)., Methods: The three groups (CH: n = 40, CBCH: n = 60, CB: n = 35) completed the Saving Inventory-Revised, the Compulsive Acquisition Scale und the Compulsive Buying Scale. Data were analysed using non-parametric tests., Results: The CBCH group did not differ from the CH group with regard to the severity of key hoarding symptoms such as clutter, difficulty discarding possessions, and the acquisition of free things, but showed a higher severity of CB than the CB group., Conclusions: While the findings indicate remarkable overlap in primary features of CH in compulsive hoarders with and without excessive buying, they suggest more severe CB in individuals with both hoarding and buying symptoms compared to individuals with only CB. Future studies should address the question whether both disorders are part of a larger construct., (© 2014 S. Karger AG, Basel.)

Compulsive production of verse is an unusual form of hypergraphia that has been reported mainly in patients with right temporal lobe seizures. We present a patient with transient epileptic amnesia and a left temporal seizure focus, who developed isolated compulsive versifying, producing multiple rhyming poems, following seizure cessation induced by lamotrigine. Functional neuroimaging studies in the healthy brain implicate left frontotemporal areas in generating novel verbal output and rhyme, while dysregulation of neocortical and limbic regions occurs in temporal lobe epilepsy. This case complements previous observations of emergence of altered behavior with reduced seizure frequency in patients with temporal lobe epilepsy. Such cases suggest that reduced seizure frequency has the potential not only to stabilize or improve memory function, but also to trigger complex, specific behavioral alterations.

Background and Objectives: Compulsive buying is a disabling condition, where individuals are unable to resist or control their buying behavior, leading to substantial social and financial problems. Cognitive models implicate the role of beliefs as one factor in buying behavior, for example, "this item is unique and will help me improve my life"., Methods: This study experimentally examined the contribution of such beliefs to the disorder, in individuals who compulsively buy (N = 18) and in non-clinical controls (N = 17). Participants were presented with photographs of idiosyncratically appealing and unappealing items, in the context of imagined scenarios that either minimized or maximized aspects relevant to hypothesized "compulsive buying beliefs" (i.e., beliefs that acquisition can compensate for negative feelings, beliefs regarding uniqueness and lost opportunities, and emotional reasons for buying)., Results: It was found that individuals who compulsively buy demonstrated stronger urges to purchase than control participants, regardless of context, but the overall strength of these urges was responsive to manipulations of beliefs about consumer items said to be associated with compulsive buying., Limitations: The main limitation of the study was a small sample size, potentially reducing power., Conclusions: Nonetheless, these findings provide insights into the processes underlying compulsive phenomena, in particular supporting the role of cognitions in compulsive buying., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Cognitive contributions to the behaviors observed in substance and non-substance addictions have been investigated and characterized. Based on models of drug addictions and the extant literature on Internet gaming disorder (IGD), we propose a cognitive-behavioral model for conceptualizing IGD. The model focuses on three domains and their roles in addictive behaviors. The three domains include motivational drives related to reward-seeking and stress-reduction, behavioral control relating to executive inhibition, and decision-making that involves weighing the pros and cons of engaging in motivated behaviors. Based on this model, we propose how behavioral therapies might target these domains in the treatment of IGD., (Copyright © 2014 Elsevier Ltd. All rights reserved.)