ABSTRACT
PURPOSE OF REVIEW: The current serotonin-based biological model of suicidal behavior (SB) may be too simplistic. There is emerging evidence that other biomarkers and biological systems may be involved in SB pathophysiology. The literature on the endocannabinoid (EC) systems and SB is limited. The objective of the present article is to review all available information on the relationship between cannabinoid receptors (CB1 and CB2 receptors), and SB and/or psychological pain. RECENT FINDINGS: Our review is limited by the small number and heterogeneity of studies identified: (1) an autopsy study describing elevated levels of CB1 receptor activity in the prefrontal cortex and suicide in both depression and alcoholism and (2) studies supporting the involvement of both CB1 and CB2 receptors in the regulation of neuropathic pain and stress-induced analgesia. We conclude that cannabinoid receptors, particularly CB1 receptors, may become promising targets for the development of novel therapeutic tools for the treatment of SB.
Subject(s)
Mental Disorders/metabolism , Mental Disorders/psychology , Receptor, Cannabinoid, CB1/metabolism , Receptor, Cannabinoid, CB2/metabolism , Suicide/psychology , Animals , HumansABSTRACT
INTRODUCTION: Behavioral addictions such as gambling, sun-tanning, shopping, Internet use, work, exercise, or even love and sex are frequent, and share many characteristics and common neurobiological and genetic underpinnings with substance addictions (i.e., tolerance, withdrawal, and relapse). Recent literature suggests that both non-suicidal self-injury (NSSI) and suicidal behavior (SB) can also be conceptualized as addictions. The major aim of this mini review is to review the literature and explore the neurobiological and psychological mechanisms underlying the addiction to self-harming behaviors. METHOD: This is a narrative review. The authors performed literature searches in PubMed and Google for suicidal behavior, self-harming, addiction, and "major repeaters." Given the scarce literature on the topic, a subset of the most closely related studies was selected. The authors also focused on three empirical studies testing the hypothesis that major repeaters (individuals with ≥5 lifetime suicide attempts) represent a distinctive suicidal phenotype and are the individuals at risk of developing an addiction to SB. RESULTS: The authors reviewed the concept of behavioral addictions and major repeaters, current empirical evidence testing concerning whether or not NSSI and SB can be understood as "addictions," and the putative mechanisms underlying them. CONCLUSION: Our review suggests that both NSSI and SB can be conceptualized as addictions. This is relevant because if some individual's self-harming behaviors are better conceptualized as an addiction, treatment approaches could be tailored to this addiction.
ABSTRACT
Se presentan los resultados terapéuticos obtenidos en la Unidad de Psicología Clínica y de la Salud de la UCM con 40 personas afectadas por los atentados del 11-M que presentaban distintos problemas psicopatológicos, en la mayoría de los casos (80%) trastornos por estrés, y que fueron atendidas con programas de intervención psicológica basados en las técnicas con mayor apoyo empírico para los trastornos por estrés (técnicas de control de la ansiedad, reestructuración cognitiva y exposición). En el 90% de los pacientes se consiguió un éxito terapéutico, elevándose esta cifra al 100% en aquellos con trastorno por estrés agudo y bajando al 67% en los que sufrían trastorno por estrés postraumático. Estos resultados sugieren que las intervenciones basadas en los tratamientos que han mostrado su eficacia para los trastornos por estrés en las condiciones ideales de los estudios experimentales, también son útiles en la práctica clínica habitual con pacientes afectados por atentados terroristas. Para ilustrar esta conclusión, se presentan además dos estudios de caso único en los que se aplicó el programa de intervención a un niño y a un adulto que sufrían trastorno por estrés postraumático (AU)
This paper shows therapeutic results from the Complutense University Clinical and Health Psychology Unit, involving 40 March 11 patients with a variety of psychopathological disorders. Most cases (80 percent) showed stress disorders and were treated by means of psychological intervention stress programs with the highest experimental anchor (e.g., anxiety control technique, cognitive re-structuring and exposure). Treatment was successful in 90 percent of patients in general, 100 percent of patients with acute stress, and 67 percent of patients suffering from PTSD. This outcome suggests that interventions based on treatments that have proved effective with stress disorders in the ideal conditions of experimental studies, are also useful for usual clinical practice with people affected by terrorist attacks. In order to illustrate this conclusion, two additional studies are presented (both N=1) where the intervention program was used with a child an adult, both suffering from post-traumatic stress disorder (AU)
