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21-Apr-2019
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Arch Hellen Med, 37(3), May-June 2019, 393-411 SPECIAL ARTICLE The biopsychosocial model of addiction D. Papantos, E. Kafetzopoulos |
Addiction has traditionally been considered as a multifactorial phenomenon, but the multifactorial (biopsychosocial) model proposed to explain it had a deductive character, emanating from the need for the collaboration and cooperation of professionals from different scientific fields. This literature review presents the most important recent studies that have contributed to the emergence of an inductive multifactorial model, focusing on the interactions of the biological, psychological and social factors of addiction. Recent research of the addiction mechanism has shown that addiction is a chronic brain disease, and that all addictive substances lead to severe morphological and functional changes in various brain structures. Specially affected are the reward system, controlling drive and saliency, and the prefrontal cortex, controlling the satisfaction of drive and saliency, according to experience, learning and the long-term goals of behavior, which are developed in the growing person through family, social, and other environmental interactions. Recent genetic research has shed light on these interactions, explaining how the genes that control the biological mechanisms of liking and wanting, mainly through dopaminergic neurotransmission, interact with environmental factors to shape an endophenotype vulnerable to addiction and other types of high risk behavior.
Key words: Addiction, Dopamine, Environmental factors, Genetic factors, Reward system.