Exploring Gender and Sex Differences in Behavioral Dyscontrol: from Drug Addiction to Impulse Control Disorders

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Background

The term “addiction” is traditionally linked to the abuse of legal and illegal substances. However, engaging in non-drug related activities, especially those involving ‘natural’ rewards, could also activate the reward system and engender persistent behaviour, and diminished control over that behaviour. Non-drug addictive behaviours are commonly defined “behavioural addictions”. This definition encompasses any behaviour characterized by the followings: i) feeling of tension or arousal before the action; ii) gratification and/or relief at the time of performing the act; iii) inability to resist an urge or drive even against great obstacles or dangers; iv) absence of consideration for the negative consequences that may affect family, friends, and/or work. As such, behavioural addictions include compulsive food intake and sexual activity, pathological gambling and Internet addiction, excessive exercising, compulsive buying and pyromania. These behaviours, often referred to as "impulse control disorders" resulting in actions that are harmful to oneself and/or others, share common features (e.g. compulsiveness, impulsivity, impaired decision-making, craving, tolerance, withdrawal, high rates of relapse), and involve dysfunction of several brain circuits. Disruption of neurobiological processes underlying both sensitivity to reward and inhibitory control can lead to compulsive behaviours. For instance, in some individuals, compulsive drug-taking and compulsive food intake may result in drug addiction obesity, respectively, and other forms of activities may deteriorate into behavioural addictions.
Males and females display different attitudes and skills, experience dissimilar emotional and psychological needs, and react differently to peer pressure, lack of full realization, or other personal and social expectations. In addition, they are differently influenced by family history, and differ in the perception of self-image and health risks. All of these factors interact with genetic background and sex hormonal fluctuations in men and women, and determine a differential propensity to develop a behavioural addiction. To complicate the matter, in men testosterone levels vary markedly over the course of the day, while in women the levels of sex hormones vary significantly depending upon the menstrual cycle, the pre- or post-menopausal age, and the use of oral contraceptives. Gender-dependent differences in the rate of initiation and frequency of misuse of addicting drugs have been widely described. Yet, men and women also differ in their propensity to become addicted to other rewarding stimuli (e.g. sex, food) or activities (e.g. gambling, exercising). The goal of the present Research Topic is to explore and summarize current evidence for gender (and sex) differences not only in drug addiction, but also in other forms of addictive behaviours. Thus, it will include studies showing gender-dependent differences in drug addiction, food addiction, compulsive sexual activity, pathological gambling, Internet addiction and physical exercise addiction. Potential risk factors and underlying brain mechanisms will be also examined, with particular emphasis given to the role of sex hormones in modulating addictive and compulsive behaviours.

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