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Comparison of brain connectivity between Internet gambling disorder and Internet gaming disorder: A preliminary study

Author(s): Sujin Bae,Doug Hyun Han,Jaebum Jung,Ki Chun Nam,Perry F. Renshaw / Language(s): English Issue: 4/2017

Given the similarities in clinical symptoms, Internet gaming disorder (IGD) is thought to be diagnostically similar to Internet-based gambling disorder (ibGD). However, cognitive enhancement and educational use of Internet gaming suggest that the two disorders derive from different neurobiological mechanisms. The goal of this study was to compare subjects with ibGD to those with IGD. Methods: Fifteen patients with IGD, 14 patients with ibGD, and 15 healthy control subjects were included in this study. Resting-state functional magnetic resonance imaging data for all participants were acquired using a 3.0 Tesla MRI scanner (Philips, Eindhoven, The Netherlands). Seed-based analyses, the three brain networks of default mode, cognitive control, and reward circuitry, were performed. Results: Both IGD and ibGD groups demonstrated decreased functional connectivity (FC) within the default-mode network (DMN) (family-wise error p < .001) compared with healthy control subjects. However, the IGD group demonstrated increased FC within the cognitive network compared with both the ibGD (p < .01) and healthy control groups (p < .01). In contrast, the ibGD group demonstrated increased FC within the reward circuitry compared with both IGD (p < .01) and healthy control subjects (p < .01). Discussion and conclusions: The IGD and ibGD groups shared the characteristic of decreased FC in the DMN. However, the IGD group demonstrated increased FC within the cognitive network compared with both ibGD and healthy comparison groups.

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Internet gambling and risk-taking among students: An exploratory study

Author(s): Jessica Mcbride,Jeffrey Derevensky / Language(s): English Issue: 2/2012

Internet gambling is undergoing a massive worldwide expansion. The relationship between the convenience, anonymity, and the 24-hour availability of Internet gambling and problem gambling in young people presents a serious concern. This study explored general gambling behavior, including Internet gambling (with and without money), problem gambling, and risk-approach motivation in a sample of university students aged 18 to 20 years. Methods: University undergraduates (N = 465) in two urban universities completed in-class paper-and-pencil questionnaires concerning Internet gambling, risk taking, and a checklist of the DSM-IV criteria for problem gambling. Results: Overall, 8.0% of participants reported past-year gambling for money on the Internet, with significantly higher rates among males (11.8%) than females (0.6%). Based on DSM-IV criteria, 3.7% of respondents were classified as problem gamblers (i.e., endorsed 3 or more items). There were higher rates of problem gambling among those who had gambled on the Internet, and students who had gambled on the Internet had higher risk-approach scores. Conclusions: The results of this study suggest that students who have gambled on the Internet have greater risk-taking motivation than students who have not gambled online, and those classified as problem gamblers have greater risk-taking motivation than non-gamblers. Results also suggest both higher risk taking scores and classification as a high risk-taker predict online gambling. Gambling on the Internet may be harmful for some individuals; young males, those with high risk-approach motivation, and, most certainly, those already exhibiting problem gambling behaviors.

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Getting access to the self: Effects of self-management therapy on the development of self-regulation and inhibitory control in obese adolescents

Author(s): Marlies Pinnow,Bruce Kirkcaldy / Language(s): English Issue: 2/2012

This study investigated the role of self-regulation competencies in general and specifically in a food-related context for the control of body weight in a three-year weight loss program. Methods: The sample consisted of 30 male and female adolescents (age range: 11–18 years) who participated in a three-year therapy program for severe obesity (mean BMI at the beginning of the intervention was 33.6). Assessment of self-regulation competencies was conducted at three different stages (1st–3rd graduation/class year). Therefore, three independent groups of adolescents (N = 10) at these different stages were tested (initial- to final-stage of therapy). At the time of testing the BMI of these groups significantly differed from 38.8 to 28.7. Analyses of covariance were performed to determine whether the adolescents also differed in self-regulation skills like “resistance to temptation” and food-related Stroop interference along with ameliorating their energy-balance regulation. Results: In addition to the main effects of age and body mass index, adolescents further displayed significant improvements of executive functions with respect to resistance to temptation and inhibition. Conclusions: Interventions aimed at enhancing energy-balance regulation in adolescents may further benefit from efforts to facilitate executive functions such as self-regulation and food-related cognitive inhibition.

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Book Reviews

Author(s): Anikó Maráz,Áron Gyepesi / Language(s): English Issue: 1/2012

Review of: 1. Nancy M. Petry Pathological gambling: Etiology, comorbidity, and treatment American Psychological Association, Washington, DC, 2006, x + 417 pp. ISBN 1-59147-173-7 by: Áron Gyepesi 2. Marvin Zuckerman Sensation seeking and risky behavior American Psychological Association, Washington, DC, 2008, xix+309 pp. ISBN 1-59147-738-7 by: Áron Gyepesi 3. G. J. Madden and W. K. Bickel (Eds.) Impulsivity: The behavioral and neurological science of discounting American Psychological Association, Washington, DC, 2010, 453 pp. ISBN 9781433804779 by: Anikó Maráz

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Közöny, erőszak, család, iskola. Példák az irodalomból

Author(s): András Veres / Language(s): Hungarian Issue: 3/2008

András Veres points out the connections between aggressions and insensitivity both in the family and in the school. Aggressions in the family are complicated to study because of the traditional patterns and hierarchy of the Hungarian families. In a long historical process, families lose their influence in the socialisation process (late XIXth century) while schools take over the role of conveying the hierarchical structure of the community and the society. As the history goes on, schools will also lose their respective role in conveying social hierarchy. This phase of the change can be experienced in the present day growth of school aggression.

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Iskolai kriminalitás az USA-ban

Author(s): Ágota Dobos / Language(s): Hungarian Issue: 3/2008

The review of: „Indicators of School Crime and Safety“ 2007. U.S. Department of Education, U.S. Department of Justice Office of Justice Programs. 227 p.

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Die kroatische Sprache im Burgenland heute

Author(s): Gerhard Neweklowsky / Language(s): German Issue: 1-2/2006

The paper gives a survey of the situation of Burgenland Croatian today. The Croats of the former Western Hungarian lands originate mostly from the 16th century. Their present number is approximately 20000 in Austria, and even smaller in Hungary and Slovakia. The Croats in Austria are bi-lingual, Croatian and German. Their literary language is a Čakavian, ikavian-ekavian variety of Croatian, which has been written since the 17th century. Efforts to standardize the language have resulted in dictionaries and a grammar recently. Language contacts between Burgenland Croatian on the one hand, and Standard Croatian, German, and Hungarian on the other are described. Language policy is not very much in favor of the Croats. Nevertheless have they achieved better presence in the mass media during the last years. The linguistic usage of bi-lingual individuals differs according to age, sex, and profession. Bi-lingual instruction is conducted in a small number of schools only.

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Gray matter differences in the anterior cingulate and orbitofrontal cortex of young adults with Internet gaming disorder: Surface-based morphometry

Author(s): Deokjong Lee,Jinsick Park,Kee Namkoong,In Young Kim,Young-Chul Jung / Language(s): English Issue: 1/2018

Altered risk/reward decision-making is suggested to predispose individuals with Internet gaming disorder (IGD) to pursue short-term pleasure, despite long-term negative consequences. The anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC) play important roles in risk/reward decision-making. This study investigated gray matter differences in the ACC and OFC of young adults with and without IGD using surface-based morphometry (SBM). Methods: We examined 45 young male adults with IGD and 35 age-matched male controls. We performed region of interest (ROI)-based analyses for cortical thickness and gray matter volume (GMV) in the ACC and OFC. We also conducted whole-brain vertex-wise analysis of cortical thickness to complement the ROI-based analysis. Results: IGD subjects had thinner cortices in the right rostral ACC, right lateral OFC, and left pars orbitalis than controls. We also found smaller GMV in the right caudal ACC and left pars orbitalis in IGD subjects. Thinner cortex of the right lateral OFC in IGD subjects correlated with higher cognitive impulsivity. Whole-brain analysis in IGD subjects revealed thinner cortex in the right supplementary motor area, left frontal eye field, superior parietal lobule, and posterior cingulate cortex. Conclusions: Individuals with IGD had a thinner cortex and a smaller GMV in the ACC and OFC, which are critical areas for evaluating reward values, error processing, and adjusting behavior. In addition, in behavioral control-related brain regions, including frontoparietal areas, they also had thinner cortices. These gray matter differences may contribute to IGD pathophysiology through altered risk/reward decision-making and diminished behavioral control.

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The links between healthy, problematic, and addicted Internet use regarding comorbidities and self-concept-related characteristics

Author(s): Tagrid Leménager,Sabine Hoffmann,Julia Dieter,Iris Reinhard,Karl Mann,Falk Kiefer / Language(s): English Issue: 1/2018

Addicted Internet users present with higher rates of comorbidities, e.g., attention-deficit hyperactivity disorder (ADHD), depressive, and anxiety disorders. In addition, deficits in self-concept-related characteristics were found in addicted Internet gamers and social network users. The aim of this study was to examine the links between healthy, problematic, and addicted Internet use regarding comorbidities and self-concept-related characteristics. The association between recently developed ADHD-like symptoms without an underlying diagnosis and addictive Internet use was also examined. Methods: n = 79 healthy controls, n = 35 problematic, and n = 93 addicted Internet users were assessed for comorbidities, social and emotional competencies, body image, self-esteem, and perceived stress. Apart from an ADHD-diagnosis, recently developed ADHD-like symptoms were also assessed. Results: Addicted users showed more self-concept-related deficits and higher rates of comorbidities with ADHD, depressive, and anxiety disorders. Addicted and problematic users showed similarities in the prevalence of cluster B personality disorders and decreased levels of characteristics related to emotional intelligence. Participants with recently developed ADHD-like symptoms scored higher in lifetime and current severity of Internet use compared with those without ADHD symptoms. Addicted participants with recently developed ADHD symptoms showed higher lifetime Internet use severity compared with those without any symptoms. Conclusions: Our findings indicate that cluster B personality disorders and premorbid problems in emotional intelligence might present a link between problematic and addictive Internet use. Furthermore, the findings provide a first indication that addictive Internet use is related to ADHD-like symptoms. Symptoms of ADHD should therefore be assessed against the background of possible addicted Internet use.

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The immediate and long-term effects of time perspective on Internet gaming disorder

Author(s): Kateřina Lukavská / Language(s): English Issue: 1/2018

This study focuses on the role of time perspective (TP) in Internet gaming disorder (IGD). An inventory-based study on 377 massive multiplayer online role playing game players was conducted, followed by a 3-year-follow-up in which 48 active players from the original sample participated. We proposed that TP factors (negative TP and future positive TP) will influence either the current presence of IGD symptoms or the further development of IGD over time. In other words, the effect of TP is stable. Finally, game usage patterns were analyzed in the sense of changes in playing time and IGD symptoms in gamers after 3 years. Methods: To access the variables, two scales were administered through online inventory, the Zimbardo Time Perspective Inventory-short, and Charlton and Danforths’ Core Addiction Scale, both in 2012 (N = 377) and 2015 (N = 48). The amount of time that gamers usually spent playing were obtained through self-reports. Results: The study’s primary presumptions were confirmed. Both negative TP and future positive TP were confirmed as significant predictors of the presence of IGD symptoms, either immediately or in the following 3 years. Data on game usage showed a significant decrease in playing time and IGD symptoms between year 0 and year 3 of the study.

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The effectiveness of a parental guide for prevention of problematic video gaming in children: A public health randomized controlled intervention study

Author(s): Elfrid Krossbakken,Torbjørn Torsheim,Rune Aune Mentzoni,Daniel L. King,Bjørn Bjorvatn,Ingjerd Meen Lorvik,Ståle Pallesen / Language(s): English Issue: 1/2018

Excessive use of video games among children and adolescents is a growing concern. The aim of this study was to investigate the effectiveness of a brief parental guide with advices and strategies for regulating video gaming in children. Methods: A random sample of guardians of children between the age of 8–12 years old (N = 5,864) was drawn from the Norwegian Population Registry and equally randomized into an intervention and a control condition. A parental guide based on clinical and research literature was distributed by postal mail to those in the intervention condition. A 4-month follow-up survey comprising questions about problematic video gaming, gaming behavior, sleep activity, and parental video game regulation behavior was administered. Results: Independent t-tests revealed no significant differences between the two conditions (N = 1,657, response rate 30.1%) on any outcome measure. An ANOVA with planned comparisons showed that respondents who reported that they had read and followed the parental guide reported more video game problems and used more parental mediation strategies than those who did not read and follow the guide. Conclusions: We found no evidence for the effectiveness of the psychoeducational parental guide on preventing problematic video gaming in children. However, the guide was read and positively assessed by a significant proportion of guardians. Differences between those who studied the guide and those who did not may indicate that parental guides are better aimed at providing important information to those who already have problems rather than as a mean of primary prevention.

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Prevalence and associated factors of Internet gaming disorder among community dwelling adults in Macao, China

Author(s): Anise M.S. Wu,Juliet Honglei Chen,Kwok-Kit Tong,Shu Yu,Joseph T.F. Lau / Language(s): English Issue: 1/2018

Internet gaming disorder (IGD) has been mainly studied among adolescents, and no research to date has examined its prevalence in general Chinese adult populations. This study estimated the prevalence of probable IGD in community-dwelling adults in Macao, China. Associations between IGD and psychological distress (i.e., depression and anxiety) as well as IGD and character strength (i.e., psychological resilience and purpose in life) were also tested. Methods: A random, representative sample of 1,000 Chinese residents (44% males; mean age = 40.0) was surveyed using a telephone poll design from October to November 2016. Results: The estimated prevalence of probable IGD was 2.0% of the overall sample and 4.3% among the recent gamers (n = 473), with no statistically significant sex and age effects observed (p > .05). The two most prevalent IGD symptoms were mood modification and continued engagement, despite negative consequences. Probable IGD respondents were more vulnerable to psychological distress (25.0% and 45.0% for moderate or above levels of depression and anxiety, respectively) than their non-IGD counterparts. They also reported a lower level of psychological resilience than non-IGD respondents. No significant buffering effect of the two character strength variables on the distress–IGD relationship was found. Discussion and conclusions: These results provide empirical evidence that IGD is a mental health threat not only to adolescents but also to adults. IGD was significantly associated with psychological distress, which should be addressed in conjunction with IGD symptoms in interventions. Inclusion of gamers of both sexes and different age groups in future prevention programs is also recommended.

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Psychometric evaluation of Persian Nomophobia Questionnaire: Differential item functioning and measurement invariance across gender

Author(s): Chung-Ying Lin,Mark D. Griffiths,Amir H. Pakpour / Language(s): English Issue: 1/2018

Research examining problematic mobile phone use has increased markedly over the past 5 years and has been related to “no mobile phone phobia” (so-called nomophobia). The 20-item Nomophobia Questionnaire (NMP-Q) is the only instrument that assesses nomophobia with an underlying theoretical structure and robust psychometric testing. This study aimed to confirm the construct validity of the Persian NMP-Q using Rasch and confirmatory factor analysis (CFA) models. Methods: After ensuring the linguistic validity, Rasch models were used to examine the unidimensionality of each Persian NMP-Q factor among 3,216 Iranian adolescents and CFAs were used to confirm its four-factor structure. Differential item functioning (DIF) and multigroup CFA were used to examine whether males and females interpreted the NMP-Q similarly, including item content and NMP-Q structure. Results: Each factor was unidimensional according to the Rach findings, and the four-factor structure was supported by CFA. Two items did not quite fit the Rasch models (Item 14: “I would be nervous because I could not know if someone had tried to get a hold of me;” Item 9: “If I could not check my smartphone for a while, I would feel a desire to check it ”). No DIF items were found across gender and measurement invariance was supported in multigroup CFA across gender. Conclusions: Due to the satisfactory psychometric properties, it is concluded that the Persian NMP-Q can be used to assess nomophobia among adolescents. Moreover, NMP-Q users may compare its scores between genders in the knowledge that there are no score differences contributed by different understandings of NMP-Q items.

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Problematic smartphone use, nature connectedness, and anxiety

Author(s): Miles Richardson,Zaheer Hussain,Mark D. Griffiths / Language(s): English Issue: 1/2018

Smartphone use has increased greatly at a time when concerns about society’s disconnection from nature have also markedly increased. Recent research has also indicated that smartphone use can be problematic for a small minority of individuals. Methods: In this study, associations between problematic smartphone use (PSU), nature connectedness, and anxiety were investigated using a cross-sectional design (n = 244). Results: Associations between PSU and both nature connectedness and anxiety were confirmed. Receiver operating characteristic (ROC) curves were used to identify threshold values on the Problematic Smartphone Use Scale (PSUS) at which strong associations with anxiety and nature connectedness occur. The area under the curve was calculated and positive likelihood ratios used as a diagnostic parameter to identify optimal cut-off for PSU. These provided good diagnostic ability for nature connectedness, but poor and non-significant results for anxiety. ROC analysis showed the optimal PSUS threshold for high nature connectedness to be 15.5 (sensitivity: 58.3%; specificity: 78.6%) in response to an LR+ of 2.88. Conclusions: The results demonstrate the potential utility for the PSUS as a diagnostic tool, with a level of smartphone use that users may perceive as non-problematic being a significant cut-off in terms of achieving beneficial levels of nature connectedness. Implications of these findings are discussed.

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Both active and sham low-frequency rTMS single sessions over the right DLPFC decrease cue-induced cravings among pathological gamblers seeking treatment: A randomized, double-blind, sham-controlled crossover trial

Author(s): Anne Sauvaget,Samuel Bulteau,Alice Guilleux,Juliette Leboucher,Anne Pichot,Pierre Valrivière,Jean-Marie Vanelle,Véronique Sébille-Rivain,Marie Grall-Bronnec / Language(s): English Issue: 1/2018

Craving is a core symptom of addictive disorders, such as pathological gambling for example. Over the last decade, several studies have assessed the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the addiction field, which triggers the dorsolateral prefrontal cortex (DLPFC) to decrease craving. The STIMJEU study investigated whether a single session of low-frequency (LF, i.e., 1 Hz) rTMS applied to the right DLPFC reduced cueinduced gambling craving in a sample of treatment-seeking pathological gamblers. Methods: Thirty patients received both active and sham rTMS in random order and were blinded to the condition in a within-subject crossover design. Outcome measures included self-reported gambling craving (Visual Analog Scale and Gambling Craving Scale) and physiological measures (heart rate and blood pressure). Results: The rTMS sessions were associated with a significant decrease in the gambling urge, regardless of whether the session was active or sham. When controlling cue-induced craving levels, no effects were observed on craving for active rTMS. Overall, rTMS was well-tolerated, and the credibility of the sham procedure was assessed and appeared to be appropriate. Conclusions: We failed to demonstrate the specific efficacy of one session of LF rTMS to decrease cue-induced craving in pathological gamblers. A strong placebo-effect and rTMS parameters may partly explain these results. Yet, we are convinced that rTMS remains a promising therapeutic method. Further studies are required to examine its potential effect.

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Age-related physical and psychological vulnerability as pathways to problem gambling in older adults

Author(s): Adrian Parke,Mark D. Griffiths,Julie Pattinson,David Keatley / Language(s): English Issue: 1/2018

To inform clinical treatment and preventative efforts, there is an important need to understand the pathways to late-life gambling disorder. Aims: This study assesses the association between age-related physical health, social networks, and problem gambling in adults aged over 65 years and assesses the mediating role of affective disorders in this association. Methods: The sample comprised 595 older adults (mean age: 74.4 years, range: 65–94 years; 77.1% female) who were interviewed using a structured questionnaire to assess physical frailty, geriatric pain, loneliness, geriatric depression, geriatric anxiety, and problem gambling. Results: Pathway analysis demonstrated associations between these variables and gambling problems, providing a good fit for the data, but that critically these relationships were mediated by both anxiety and depression symptoms. Conclusions: This study indicates that late-life problem gambling may develop as vulnerable individuals gamble to escape anxiety and depression consequent to deteriorating physical well-being and social support. When individuals develop late-life problem gambling, it is recommended that the treatment primarily focuses upon targeting and replacing avoidant coping approaches.

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Does the uptake of wagering inducements predict impulse betting on sport?

Author(s): Nerilee Hing,Alex M.T. Russell,En Li,Peter Vitartas / Language(s): English Issue: 1/2018

Marketing inducements for addictive products, such as wagering, can prompt impulse purchasing by triggering consumption reminders, urges, and cravings. Wagering inducements incentivize betting by providing bonus bets, money-back guarantees, deposits into betting accounts, and discounts. Their promotion during sporting events, push marketing efforts directed at consumers, and ease of uptake at the point-of-sale, may trigger betting on impulse. This study examined whether the uptake of wagering inducements predicted impulse betting on sport. Methods: Australian sports bettors (N = 1,813) completed an online survey measuring their proportion of planned bets, impulse bets before match commencement, and impulse bets during play; frequency of using wagering inducements; and several psychological, behavioral, and demographic variables. Results: More frequent users of wagering inducements had a greater tendency to place impulse in-play bets, which were also predicted by problem gambling, higher buying impulsiveness, higher frequency of watching sports, younger age, and higher educational status. Sports bettors with a greater tendency to place impulse bets before match commencement also tended to have higher buying impulsiveness and to be younger, but they used inducements less frequently, and tended to be female, less-educated and non-problem, moderate risk, or problem gamblers. Discussion and conclusions: Uptake of wagering inducements appeared to be particularly effective in stimulating impulse in-play betting among problem gamblers and frequent sports viewers. These results suggest that a more cautious approach to the regulation of both in-play bets and wagering inducements may be required to better protect young adults from gambling problems and harm.

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Instagram addiction and the Big Five of personality: The mediating role of self-liking

Author(s): Mark D. Griffiths,Kagan Kircaburun / Language(s): English Issue: 1/2018

Recent research has suggested that social networking site use can be addictive. Although extensive research has been carried out on potential addiction to social networking sites, such as Facebook, Twitter, YouTube, and Tinder, only one very small study has previously examined potential addiction to Instagram. Consequently, the objectives of this study were to examine the relationships between personality, self-liking, daily Internet use, and Instagram addiction, as well as exploring the mediating role of self-liking between personality and Instagram addiction using path analysis. Methods: A total of 752 university students completed a self-report survey, including the Instagram Addiction Scale (IAS), the Big Five Inventory (BFI), and the Self-Liking Scale. Results: Results indicated that agreeableness, conscientiousness, and self-liking were negatively associated with Instagram addiction, whereas daily Internet use was positively associated with Instagram addiction. The results also showed that self-liking partially mediated the relationship of Instagram addiction with agreeableness and fully mediated the relationship between Instagram addiction with conscientiousness. Discussion and conclusions: This study contributes to the small body of literature that has examined the relationship between personality and social networking site addiction and is one of only two studies to examine the addictive use of Instagram and the underlying factors related to it.

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Cognitive inflexibility in a young woman with pyromania

Author(s): Austin W. Blum,Brian L. Odlaug,Jon E. Grant / Language(s): English Issue: 1/2018

Pyromania is a rare disorder that is characterized by multiple episodes of deliberate and purposeful firesetting. It is typically associated with significant psychosocial dysfunction and legal problems. Even so, little research has examined cognitive aspects of the disorder. Case presentation/study: In this study, we compared a 24-year-old woman with pyromania with 19 age- and gender-matched healthy controls using a battery of computerized neurocognitive tasks. Our participant affected by pyromania showed impaired cognitive flexibility but intact functioning on measures of impulsive action and decision-making. Discussion: Although pyromania shares phenomenological similarities with other urge-driven disorders, our results suggest that pyromania may have features of compulsivity as well. Conclusions: Pyromania is relatively understudied from a neurobiological perspective. Further research is needed to understand the pathophysiology, classification, and treatment of pyromania.

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Pro-dopamine regulator, KB220Z, attenuates hoarding and shopping behavior in a female, diagnosed with SUD and ADHD

Author(s): Thomas Mclaughlin,Kenneth Blum,Bruce Steinberg,Edward J. Modestino,Lyle Fried,David Baron,David Siwicki,Eric R. Braverman,Rajendra D. Badgaiyan / Language(s): English Issue: 1/2018

Addictive-like behaviors (e.g., hoarding and shopping) may be the result of the cumulative effects of dopaminergic and other neurotransmitter genetic variants as well as elevated stress levels. We, therefore, propose that dopamine homeostasis may be the preferred goal in combating such challenging and unwanted behaviors, when simple dopaminergic activation through potent agonists may not provide any resolution. Case presentation: C.J. is a 38-year-old, single, female, living with her mother. She has a history of substance use disorder as well as attention deficit hyperactivity disorder, inattentive type. She had been stable on buprenorphine/naloxone combination and amphetamine, dextroamphetamine mixed salts for many years when unexpectedly she lost her job for oversleeping and not calling into work. KB200z (a pro-dopamine compound) was added to her regimen for complaints of low drive and motivation. After taking this nutraceutical for 4 weeks, she noticed a marked improvement in her mental status and many behaviors. She noted that her shopping and hoarding addictions had appreciably decreased. Furthermore, her lifelong history of terrifying lucid dreams was eliminated. Finally, she felt more in control; her locus of control shifted from external to more internal. Discussion: The hypothesis is that C.J.’s reported, behavioral, and psychological benefits resulted from the pro-dopamine-regulating effect of KB220Z across the brain reward system. Conclusions: This effect, we surmise, could be the result of a new dopamine balance, across C.J.’s brain reward system. Dopamine homeostasis is an effect of KB220Z seen in both animal and human placebo-controlled fMRI experiments.

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