Precision Behavioral Management (PBM) and Cognitive Control as a Potential Therapeutic and Prophylactic Modality for Reward Deficiency Syndrome (RDS): Is There Enough Evidence?

Abstract

This brief commentary aims to provide an overview of the available and relatively new precision management of reward deficiencies manifested as substance and behavioral disorders. Current and future advances, concepts, and the substantial evidential basis of this potential therapeutic and prophylactic treatment modality are presented. Precision Behavioral Management (PBM), conceptualized initially as Precision Addiction Management (PAM), certainly deserves consideration as an important modality for the treatment of impaired cognitive control in reward processing as manifested in people with neurobiologically expressed Reward Deficiency Syndrome (RDS).

Invited Expert Opinion- Bio-informatic and Limitation Di-rectives to Help Adopt Ge-netic Addiction Risk Screening and Identify Preaddictive Reward Dysregulation: Re-quired Analytic Evidence to Induce Dopamine Homeo-statsis

“…Recently, large GWAS studies have revealed a significant dopaminergic gene risk polymorphic allele overlap between depressed and schizophrenic cohorts [157]. A large volume of literature has also identified ADHD, PTSD, and spectrum disorders as having the known neurogenetic and psychological underpinnings of RDS [158][159][160].…”

Genetic Addiction Risk and Psychological Profiling Analyses for “Preaddiction” Severity Index

“…Theoretical models of addictive disorders handling 'addictions' as a common disorder instead of distinct conditions have already been proposed in the 1980s [14]. More recent research also encourages considering addiction not as a collection of [15] different disorders but as a symbolic umbrella under which all addiction types can be classified. Additionally, Hollander's obsessive-compulsive spectrum disorder (OCSD) model suggests a shared obsessive-compulsive spectrum in the background of psychiatric diseases of different diagnostic categories [15,16].…”

“…More recent research also encourages considering addiction not as a collection of [15] different disorders but as a symbolic umbrella under which all addiction types can be classified. Additionally, Hollander's obsessive-compulsive spectrum disorder (OCSD) model suggests a shared obsessive-compulsive spectrum in the background of psychiatric diseases of different diagnostic categories [15,16]. Furthermore, Blum, Cull, Braverman, and Comings in 1996 [17] proposed in the Reward Deficiency Syndrome that the development of impulsive and addictive behaviors shares some common psychological and molecular pathways.…”

“Preaddiction” construct and reward deficiency syndrome: genetic link via dopaminergic dysregulation

“…The implication here is that reward is a key element of mental operation that has evolved beyond immediate survival, and it is crucial for most individual and social activities, including emotional attachments, group affiliations, free will, conformity, and obedience to societal norms and edicts (29)(30)(31)(32)(33). Consequently, the lives of individuals with RDS may be intolerable due to their inability to gain full satisfaction from their accomplishments while overcoming the same challenges as others.…”