Craving has been defined as the motivation to self-administer a substance previously consumed. It has been hypothesized that craving contributes significantly to compulsive drug use and relapse after a period of abstinence in humans. Neuropsychological and brain-imaging studies have identified numerous brain regions that may be involved in craving. In this paper, the neuropsychological mechanisms of craving for nicotine are reviewed, focusing on three systems that appear to be involved in craving states. First of all, the reward system, responsible for the development of dependence and craving. Secondly, the emotional and associative system, which is related to conditioned craving. And third, the system involved in the neural basis of cognitive and decisionmaking processes. The most influential theoretical models on craving are also reviewed, including those based on conditioning mechanisms, on cognitive mechanisms and on cognitive-behavioral mechanisms, as well as the neurobiological model. Factors related to the evaluation and treatment of craving are also discussed, with particular emphasis on clinical aspects. Finally, we stress the importance of a multidisciplinary approach for achieving a common model on craving and improving the diagnostic tools and treatment strategies.Key words: craving, smoking, neuropsychological mechanisms, nicotine dependence, theoretical models. RESUMEN ABSTRACTEl craving se ha definido como la motivación de autoadministrarse una sustancia que previamente ha sido consumida. Se considera que el craving es responsable del consumo compulsivo de una sustancia, así como del alto nivel de recaídas después de periodos de abstinencia. Los estudios neuropsicológicos y de imagen cerebral han identificado numerosas regiones cerebrales implicadas en el craving. En este artículo se revisan los mecanismos neuropsicológicos implicados en el craving por la nicotina, centrándose en los tres sistemas involucrados en el craving. Primero, el sistema de recompensa, responsable del desarrollo de la dependencia y del craving. Segundo, el sistema emocional y asociativo que se relaciona con el craving condicionado. Tercero, el sistema implicado en la toma de decisiones y procesos cognitivos. Además, se revisa los modelos teóri-cos más influyentes, como los Modelos basados en el Condicionamiento, Modelos Cognitivo-Conductuales, Modelos Cognitivos y Modelo Neurobiológico. También se discuten otros aspectos relacionados con la evaluación y tratamiento del craving, haciendo énfasis en los aspectos clínicos. Como conclusión, se acentúa la importancia de un enfoque multidisciplinar para lograr un modelo común del craving, así como para mejorar las herramientas diagnósticas y las estrategias de tratamiento.
Cue-reactivity studies have shown that when consumers are exposed to a substance-related stimulus, potential tobacco use contributes significantly to craving and motivational drive. Although the motivational response to cues signaling tobacco availability has been widely studied, less is known about physiological reactivity to perceived cigarette availability. The aim of the present study was to examine the outcome-related negativity (ORN) evoked by stimuli that signal potential tobacco use in abstinent and sated smokers. The ORN is an event-related potential (ERP) component that reflects the emotional and motivational aspects of reward processing and is modulated by motivational value of reward. Thirty-two such smokers performed two distinct and comparable versions of a gambling task, under conditions of abstinence and satiation. The analysis of variance (ANOVA) analysis revealed that ORN amplitude was larger in abstinent than satisfied smokers on those trials in which tobacco could be used. Differences were significant at the Fz electrode (p < .01) and approached significance at the Cz (p = .061) and Pz (p = .059) electrodes. Moreover, ORN amplitude predicted subjective indices of desire and positive effects from smoking, but only in the abstinence condition. These findings suggest that perceived cigarette availability might influence physiological reactivity in smokers who are nicotine deprived. They also suggest that the ORN component may be related to the motivational mechanisms involved in addictive behavior.
Hypnosis is a therapeutic technique that has developed for centuries, and every time with greater clinical and scientific weight. Currently, hypnosis constitutes a solid support method for treatments against chronic pain and for emotion control under situations that generate fear and anxiety -such as surgery or other type of phobias-, so it is presented as an alternative to the use of medicine/drugs by health specialists. On the other hand within the field of behavioral sciences, apart from controlling fear and anxiety responses, hypnosis serves as support to the various cognitive behavioral techniques by facilitating their assimilation and development. This work presents a scientometric study of the research done on hypnosis over the last fifteen years, from publications -in Spanish and English- in specialized journals, indexed in SCOPUS (a specialized international bibliometric database). The contemporary applications of hypnosis are presented and critically discussed; as well as the fields in which its application has proven successful; its limitations; the research networks generated within the time of the study; plus, probable projections for future research are also mentioned.
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