Search Results (49)

Animals with knockout of the dopamine transporter gene (DAT-KO) display hyperdopaminergic phenotypes, including attention-deficit/hyperactivity-like behaviors. A previous behavioral analysis of heterozygous rats with partial knockout (DAT-HET) suggested increased susceptibility to addictive behaviors. The aim of this study was to investigate elements of addictive behaviors and the mechanisms underlying dopamine release in DAT-HET rats. Offspring derived from DAT-knockout breeding underwent genotyping and behavioral assessment using the marble burying test, a manipulative behavior test using nesting material, and a modified version of the Iowa Gambling Task. Feeding behavior was studied using a binge-eating model. Reinforcing properties were investigated using intracranial self-stimulation under fixed-ratio (FR) and variable-ratio (VR) schedules. Dopamine (DA) release and clearance dynamics were assessed using fast-scan cyclic voltammetry (FSCV). DAT-HET rats exhibited moderate hyperactivity, increased impulsive choice, and compulsive responses. Male DAT-HET rats also showed increased compulsive overeating compared with wild-type (WT) rats of both sexes and female DAT-HET rats. In addition, DAT-HET rats demonstrated a preference for VR self-stimulation, which resembles risk- and thrill-seeking behavior in humans. In DAT-KO rats, impaired DA clearance resulted from complete loss of dopamine transporter function. In DAT-HET rats, increased DA release amplitude was observed, and dopamine persisted longer in the extracellular space than in WT rats. These findings underscore the importance of the DAT-HET model for studying impulsivity, compulsivity, and factors underlying the predisposition to addictive behavior. Full article

Glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed for type 2 diabetes and obesity, have recently attracted interest as potential modulators of addictive behavior. This narrative review summarizes current knowledge on the neurobiological basis, randomized controlled trials, and psychiatric relevance of GLP-1 analogs in substance use disorders. English-language articles available at the time of the search were reviewed between February and April 2026, with emphasis on topics most relevant to psychiatric practice. The literature suggests that GLP-1 signaling influences reward processing, cue reactivity, stress responses, relapse vulnerability, and executive control through actions in the gut–brain axis and mesocorticolimbic circuitry. Early clinical findings are most encouraging in alcohol-related outcomes, including reductions in alcohol cue reactivity, craving, alcohol self-administration, and some measures of heavy drinking, whereas evidence in nicotine dependence is mixed and appears more consistent for limiting post-cessation weight gain than for improving abstinence itself. Evidence for other substance use disorders remains preliminary. Across randomized controlled trials, interpretation is limited by small sample sizes, short follow-up, heterogeneous endpoints, and selective populations. In addition, psychiatric and behavioral safety requires careful attention, particularly regarding rapid weight loss, excessive appetite suppression, restrictive eating, dehydration, and psychological destabilization in vulnerable individuals. At present, GLP-1 receptor agonists should be regarded as promising but unproven adjunctive candidates in addiction psychiatry, warranting further rigorous trials, structured monitoring, and interdisciplinary collaboration. Full article

We examined how sociodemographic, parental, and temporal factors are associated with parent-reported reasons for seeking consultation in a child and adolescent psychotherapeutic clinic. Data were derived from a large retrospective sample of more than 3000 cases collected between 2011 and 2023. Multivariable binary logistic regression analyses assessed the independent effects of age, gender, living arrangements, migration background, parental education, parental age at childbirth, parental separation or bereavement, and pandemic-related periods. School-aged children and adolescents were more likely than younger children to present with learning difficulties, depression, anxiety, mobbing and media addiction. Female patients showed lower odds of consultations related to learning difficulties, aggression, behavioral addiction, attention deficit/hyperactivity, but higher odds of depression, psychosomatic symptoms, anxiety, eating disorders and sleeping disorders. Parental separation increased the likelihood of consultations related to problematic social behavior within the family, delinquency and trauma and grief. Consultations for attention deficit/hyperactivity concerns were more frequent in the post-pandemic period compared to pre-pandemic. The findings highlight that sociodemographic, familial, and temporal factors are systematically associated with distinct patterns of parent-reported help-seeking patterns in child and adolescent psychotherapeutic care. Full article

Background/Objectives: Type 2 diabetes (T2D) affects more than 38 million Americans and remains a leading public health challenge. Behavioral self-management is central to glycemic control but is often undermined by dysregulated and addictive-like eating behaviors. Continuous glucose monitoring (CGM) offers immediate feedback that may strengthen self-regulation, yet the psychological processes linking CGM use, food addiction (FA), and behavior change are poorly understood. This secondary mixed-methods study examined how CGM-supported group medical visits (GMVs) influence glycemic outcomes and FA symptoms in adults with diabetes. Methods: Adults with T2D participated in a 14-week GMV program integrating CGM review with education on nutrition, physical activity, sleep, stress, and intermittent fasting. Thirteen participants had paired CGM summaries and psychosocial data. Quantitative outcomes included mean glucose, glycemic variability, time-in-range (TIR), and symptoms of food addiction using the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). Qualitative data came from open-ended surveys analyzed using reflexive thematic analysis. Integration followed a convergent design, merging individual change trajectories with thematic interpretations and case vignettes. Results: Mean glucose decreased by 21 mg/dL and TIR improved by 9 percentage points. Among six participants with baseline FA symptoms, all showed reductions in self-reported mYFAS 2.0 symptom counts. Four moved from mild to no symptoms, one from moderate to no symptoms, and one from severe to no symptoms. Across the full sample, the mean change was a reduction of 1.2 in the mYFAS 2.0 symptom counts per participant. Thematic analysis identified four interrelated psychological mechanisms: enhanced awareness of food–glucose relationships, increased accountability through shared tracking, motivation via gamified self-monitoring, and relief from cognitive burden associated with dietary uncertainty. Conclusions: Integrating CGM feedback into GMVs was associated with improvements in glycemic metrics and reductions in addictive-like eating symptoms in this pilot sample. These findings position CGM as a behavioral intervention tool that complements its traditional monitoring role and highlight the value of combining real-time biofeedback with group-based support in diabetes care. Full article

Background/Objectives: Food addiction (FA) and binge eating disorder share many overlapping features. Many individuals with binge eating disorder experience stigma; however, less is known about the stigma associated with food addiction. The current study examined the weight-based stigma and mental illness stigma associated with attributing disordered eating behaviours to an FA diagnosis or binge eating disorder diagnosis. Methods: Undergraduate students (N = 177) were randomly assigned to read one of three vignettes (FA, binge eating disorder, or control), all of which described a character experiencing the overlapping features of FA and binge eating disorder; the vignettes differed only regarding the diagnosis to which the eating behaviours were attributed. Participants then completed questionnaires assessing their attitudes towards mental illness and obesity followed by questionnaires assessing their own eating behaviours. Results: There were no significant between-group differences in mental illness stigma or weight-based stigma. Significant differences in stigma were found based on the perceived gender of the vignette character and participants’ own FA and binge eating disorder symptoms. Conclusions: Stigma may not differ based on the diagnosis ascribed to addictive-like eating behaviours. Women may be more stigmatized for addictive-like eating behaviours, and individuals who experience addictive-like eating may be more stigmatizing towards others with these behaviours. Full article

Background: Excessive daytime sleepiness (EDS) and fatigue are two impactful symptoms, frequently associated with sleep disorders, which can worsen the quality of life. Due to overlapping features and patient-report ambiguity a clear-cut distinction between EDS and fatigue can become a challenging issue. We aimed to investigate the prevalence and consequences of these two conditions in several sleep pathologies, examining their social, psychological, and dietary impact, with a focus on gender-related differences and occupational status. Methods: We prospectively recruited for an online survey 136 adult outpatients (60 females) affected by various sleep disorders and admitted to our Sleep Disorders Center in Parma, Italy. Patients were asked to complete the following tests: Epworth Sleepiness Scale, Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Difficulties in Emotion Regulation Scale, Depression Anxiety Stress Scale-21, Hyperarousal Scale, the Addiction-like Eating Behaviors Scale, Work Productivity and Activity Impairment Questionnaire, MEDI-Lite, and EQ-5D Health Questionnaire. Results:Fatigue was the primary daily symptom leading to serious repercussions on social/emotional and psychological well-being, while daytime sleepiness showed a less relevant role. Women reported higher levels of fatigue, sleep disturbances, emotional dysregulation, hyperarousal, and work productivity impairments. Unemployed people experienced a higher degree of fatigue, with multi-level negative consequences. Conclusions: We suggest sleep clinicians place a greater emphasis on the assessment of fatigue during clinical interviews, keeping in mind the greater vulnerability of females, experiencing disproportionate consequences. Further studies should expand our findings, exploring a wider range of gender identities and recruiting larger samples of patients. Full article

Background. Food addiction is often linked to overeating and difficulty in controlling eating habits. At the same time, food addiction is often associated with intense eating-related thoughts and emotional eating behaviors. However, despite extensive research on food addiction, the psychological processes that contribute to these outcomes have not been fully examined. Consequently, this study aims to fill that gap by investigating the influence of eating-related thoughts, as well as emotional eating behaviors that may precede episodes of uncontrolled eating. Methods. A cross-sectional design was used. A sample of 467 individuals was enrolled from the general population. Participants completed a battery of self-report questionnaires. A sequential mediation analysis with latent variables (i.e., structural equation modeling; SEM) using 5000 bootstrap samples and observed variables was performed. Results. The proposed model provides good fit indices. Indeed, food addiction predicts uncontrolled eating behaviors through eating-related thoughts (p < 0.001), which were also significantly associated with the emotion-driven eating patterns (p < 0.001), revealing a fully mediated model explaining 61.6% of the outcome variance (R² = 0.616). Discussion. The findings underscore the critical influence of cognitive factors (i.e., eating-related thoughts) in driving maladaptive coping mechanisms like emotional eating. Moreover, emotional eating may act as a precursor to behaviors associated with overeating, which are often rooted in food addiction. Conclusions. Recognizing the central role of thoughts and emotions can help clinicians develop more targeted psychological interventions for those experiencing food addiction symptoms. Full article

Background: Stroke ranks as the second leading cause of death and the third leading cause of disability in adults worldwide. While an unhealthy diet is an independent risk factor for stroke, its association with disordered eating behaviours on stroke remains overlooked. This exploratory study aimed to evaluate the prevalence and severity of addictive-like eating behaviours in stroke patients and their association with the main vascular stroke risk factors. Methods: First-ever minor or moderate stroke patients with the ability to complete self-report questionnaires were included. Addictive-like eating was assessed using the Yale Food Addiction Scale 2.0 (YFAS 2.0). The variables of interest were: (i) the proportion of patients meeting the diagnosis of food addiction (FA); (ii) FA symptoms count and severity; (iii) addictive-like eating profile severity. Their association with four main vascular risk factors (obesity, hypertension, dyslipidemia and diabetes) were tested using univariate and multivariate analyses. Results: Over a 4-month period, 101 patients (mean (standard deviation (SD)), 62.8 (13.7) years; males: 60.4%) were consecutively screened with the YFAS 2.0. Overall, 5% of the sample endorsed an FA diagnosis, and 38.6% screened positive for at least one of the symptom criteria, with the most frequently endorsed symptom being “Inability to cut down”. Dyslipidemia was the only vascular risk factor associated with the FA diagnosis (p = 0.043, 95% CI [−0.21; 0.01]). However, the severity of the addictive profile was associated with dyslipidemia (p = 0.016, 95% CI [−2.16; −0.21]) and diabetes (p = 0.038, 95% CI [−1.77; 0.25]), but only independently with dyslipidemia (p = 0.05; OR = 1.25; 95% CI [1.00; 1.56]). There were significant associations between the number of vascular risk factors and the severity of Time spent, Tolerance, and Use despite adverse consequences of FA symptoms, both in univariate and multivariate analyses (all p < 0.05). The number of vascular risk factors and total number of FA symptoms were significantly associated in univariate analyses (p = 0.007) but not after adjusting for age (p = 0.055) or sex (p = 0.083). Conclusions: This study highlighted the potential importance of addictive-like behaviours in the secondary prevention of stroke. However, larger and longer-term studies investigating addictive-like eating in diverse samples of stroke patients are warranted to achieve precision medicine. Full article

Food addiction (FA) and binge eating disorder (BED) co-occur and share compulsive eating symptoms. When using an FA measure, it is important to evaluate its performance in a population presenting compulsive eating. The study aims to validate the Addiction-like Eating Behavior Scale (AEBS) among a clinical sample characterized by compulsive eating and overweight/obesity and to evaluate its incremental validity over the Yale Food Addiction Scale 2.0 (YFAS). Patients seeking help for compulsive eating (n = 220), between January 2020 and July 2023, completed online questionnaires, including FA, compulsive eating, and BMI evaluations. The factor structure, internal consistency, and convergent, divergent, and incremental validity were tested. The sample had a mean age of 44.4 years old (SD = 12.7) and a mean BMI of 38.2 (SD = 8.0). The two-factor structure provided a good fit for the data, with factor loadings from 0.55 to 0.82 (except for item 15) and the internal consistency was high (ω = 0.84–0.89). The AEBS was positively correlated with the YFAS (r = 0.66), binge eating (r = 0.67), grazing (r = 0.47), craving (r = 0.74), and BMI (r = 0.26), and negatively correlated with dietary restraint (r = −0.37), supporting good convergent and divergent validity. For each measure of compulsive eating, linear regression showed that the AEBS “appetite drive” subscale had a unique contribution over the YFAS. This study provided evidence that the AEBS is a valid measure among a clinical sample of patients with compulsive eating and overweight/obesity. However, questions remain as to whether the AEBS is a measure of FA or compulsive eating. Full article

Ultra-processed foods (UPFs) like pastries, packaged snacks, fast foods, and sweetened beverages have become dominant in the modern food supply and are strongly associated with numerous public health concerns. While the physical health consequences of UPF intake have been well documented (e.g., increased risks of cardiometabolic conditions), less empirical discussion has emphasized the mental health consequences of chronic UPF consumption. Notably, the unique characteristics of UPFs (e.g., artificially high levels of reinforcing ingredients) influence biological processes (e.g., dopamine signaling) in a manner that may contribute to poorer psychological functioning for some individuals. Importantly, gold-standard behavioral lifestyle interventions and treatments specifically for disordered eating do not acknowledge the direct role that UPFs may play in sensitizing reward-related neural functioning, disrupting metabolic responses, and motivating subsequent UPF cravings and intake. The lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods and the utility of ultra-processed food addiction (UPFA) as a novel clinical phenotype endorsed by 14–20% of individuals across international samples. The overarching aim of the present review is to summarize the science of how UPFs may affect mental health, emphasizing contributing biological mechanisms. Specifically, the authors will (1) describe how corporate-sponsored research and financial agendas have contributed to contention and debate about the role of UPFs in health; (2) define UPFs and their nutritional characteristics; (3) review observed associations between UPF intake and mental health conditions, especially with depression; (4) outline the evidence for UPFA; and (5) describe nuanced treatment considerations for comorbid UPFA and eating disorders. Full article

Eating behaviour (EB) is a complex system affected by different factors, including food liking and psychology. Researchers have highlighted the importance of genetics in EB, but little is known. Therefore, this study aimed to investigate the genetic factors involved in EB in Italian cohorts, Friuli-Venezia Giulia (FVG) and Val Borbera (VB). Genome-Wide Association Studies (GWAS) on food liking were performed in FVG (n = 575). The relationships between the genetic findings and other variables of interest (i.e., psychological outcomes) were evaluated using linear regression models. A replication study was carried out in an independent cohort (VB, n = 701). GWAS revealed a significant association between the liking of milk chocolate and a region on chromosome 5. The most associated single nucleotide polymorphism (SNP) was rs73280705 (p = 1.02 × 10⁻⁹), an eQTL for the LARP1 gene in the nucleus accumbens (NAc). Subjects carrying the minor allele of the SNP show a reduced liking for milk chocolate, as well as a minor overall liking for a milk-based food group. The latter finding was replicated in VB (p = 0.026). Regarding the psychological data, these subjects also present a reduced impulsivity (p = 0.031). On the other hand, carriers of the counterpart allele show an increased liking for milk-based food and a high impulsivity (p = 0.023). These data are not influenced by the lactose deficiency allele. The results suggest that this genetic region could play a role in both impulsivity and food liking. Indeed, individuals carrying the LARP1 gene variant show a decrease in liking for milk chocolate and milk-based food, as well as in impulsivity, while the others are more impulsive, like more milk-based foods and, in general, sweet and fatty foods. LARP1 is expressed in the NAc, which is a central driver of reward response controlling the pleasantness and gratification given by food (mostly triggered by highly palatable foods). Moreover, the NAc also plays a role in integrating limbic system stimulation into the motor system, which can lead to addictive and impulsive behaviours. Additional studies are needed to increase our knowledge on this extremely interesting gene association and, overall, on the LARP1 gene’s relationship with milk and mTORC1, food liking, and EB. Full article

Background: Men are more likely than women to have subthreshold overeating disorders. Lifestyle plays a role as a determinant, while chronotype is an emerging factor. Chronotype explains the natural preferences of wakefulness and activity throughout the day: evening chronotypes (E-Types), those most productive in the evening, have been linked with unhealthy dietary patterns and a higher propensity to substance addiction than morning types (M-Types). Methods: We carried out a cross-sectional study on 750 overweight or obese adults (70% females, 48 ± 10 years, BMI 31.7 ± 5.8 kg/m²). The Binge-Eating Scale, the Yale Food Addiction Scale 2.0 (YFAS 2.0), the reduced Morningness-Eveningness Questionnaire (rMEQ), and the MEDAS questionnaire were used to assess binge eating, food addiction, chronotype, and adherence to the Mediterranean diet, respectively. Results: No differences in BES binge-eating and FA food-addiction scores occurred between chronotypes, but we found significant interactions between sex × rMEQ score. While women showed the same prevalence for binge eating and food addiction across all chronotypes, binge eating and food addiction risk increased with reducing rMEQ score in men, indicating that being male and E-Type increases the risk association of binge eating and/or food addiction prevalence. Conclusions: chronotype is associated with binge eating and food addiction in men, emphasizing the link between chronobiology and sex differences as determinants in appetite and eating behaviour dysregulation and in overweight and obesity. Full article

University students are a vulnerable population to the development of disordered eating, such as food addiction (FA) and grazing. FA is an emerging concept characterized by an intense desire to eat hyper-palatable foods. Grazing is characterized by the repetitive and unplanned ingestion of food throughout a period of time. Both FA and grazing have been associated with increased scores of negative urgency (NU) and difficulties in emotion regulation (ER). This study aims to evaluate the frequency of FA and grazing in a university population and to test the direct, total, and indirect effects—via FA—of ER and NU on repetitive eating and compulsive grazing. A total of 338 participants responded to a set of psychological measures assessing these variables. Thirty-six (10.7%) participants met the criteria for FA diagnosis and 184 (54.4%) presented grazing. Confirmatory factor analysis showed acceptable fit indexes for the model tested (χ²₍₁₆₉₅₎ = 3167.575; p < 0.001; CFI = 0.955; NFI = 0.908; TLI = 0.953; SRMR = 0.085; RMSEA = 0.051; CI 90% (0.048; 0.053); P[RMSEA ≤ 0.05] = 0.318) and suggested that FA partially mediated the effect of difficulties in ER and NU on grazing, specifically on compulsive grazing. The results indicate that individuals with difficulties in ER and impulse control under negative emotions are more likely to engage in grazing if food addiction scores are higher. These results highlight the importance of assessing these variables, particularly in at-risk populations such as university students. Full article

Eating disorders are multifactorial disorders that involve maladaptive feeding behaviors. Binge eating disorder (BED), the most prevalent of these in both men and women, is characterized by recurrent episodes of eating large amounts of food in a short period of time, with a subjective loss of control over eating behavior. BED modulates the brain reward circuit in humans and animal models, which involves the dynamic regulation of the dopamine circuitry. The endocannabinoid system plays a major role in the regulation of food intake, both centrally and in the periphery. Pharmacological approaches together with research using genetically modified animals have strongly highlighted a predominant role of the endocannabinoid system in feeding behaviors, with the specific modulation of addictive-like eating behaviors. The purpose of the present review is to summarize our current knowledge on the neurobiology of BED in humans and animal models and to highlight the specific role of the endocannabinoid system in the development and maintenance of BED. A proposed model for a better understanding of the underlying mechanisms involving the endocannabinoid system is discussed. Future research will be necessary to develop more specific treatment strategies to reduce BED symptoms. Full article

This article summarizes the results of studies in which functional magnetic resonance imaging (fMRI) was performed to investigate the neurofunctional activations involved in processing visual stimuli from food in individuals with anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). A systematic review approach based on the PRISMA guidelines was used. Three databases—Scopus, PubMed and Web of Science (WoS)—were searched for brain correlates of each eating disorder. From an original pool of 688 articles, 30 articles were included and discussed. The selected studies did not always overlap in terms of research design and observed outcomes, but it was possible to identify some regularities that characterized each eating disorder. As if there were two complementary regulatory strategies, AN seems to be associated with general hyperactivity in brain regions involved in top-down control and emotional areas, such as the amygdala, insula and hypothalamus. The insula and striatum are hyperactive in BN patients and likely involved in abnormalities of impulsivity and emotion regulation. Finally, the temporal cortex and striatum appear to be involved in the neural correlates of BED, linking this condition to use of dissociative strategies and addictive aspects. Although further studies are needed, this review shows that there are specific activation pathways. Therefore, it is necessary to pay special attention to triggers, targets and maintenance processes in order to plan effective therapeutic interventions. Clinical implications are discussed. Full article