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Chunk #49 — 4 Compulsivity in Alcoholism: an Allostatic View

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Theoretical frameworks and mechanistic aspects of alcohol addiction: alcohol addiction as a reward deficit disorder.
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to form the neurobiological basis for the b-process: loss of function in the reward systems (within-system neuroadaplation) and recruitment of the brain stress or anti-reward systems (between-system neuroadaptation; Koob and Bloom 1988; Koob and Le Moal 1997). Anti-reward is a construct based on the hypothesis that brain systems are in place to limit reward (Koob and Le Moal 2008). As dependence and withdrawal develop, brain stress systems, such as CRF, norepinephrine, and dynorphin, are recruited, producing aversive or stress-like states (Koob 2003; Nestler 2001; Aston-Jones et al. 1999). At the same time, within the motivational circuits of the ventral striatum-extended amygdala, reward function decreases. The combination of decreases in reward neurotransmitter function and recruitment of anti-reward systems provides a powerful source of negative reinforcement that contributes to compulsive drug-seeking behavior and addiction (Fig. 3).