心理倚賴（英語：Psychological dependence），亦稱精神倚賴，指的是在停藥、停止某項活動時因情感產生的倚賴導致的戒斷症狀（如煩躁、失樂、焦慮等）。[1][2][5]心理倚賴有時候也被認為是成癮症狀的一部分。[6]然而，有些能夠讓人產生倚賴性的藥物並不會讓人成癮，反過來也是如此。[6]成癮與心理倚賴都可通過強化（一種操作制約）來緩和症狀，但是這兩種各自有不同的強化方式。[1][2] 成癮是一種對獎勵刺激的尋求，可通過正向強化的方式減輕症狀。[1][2]心理倚賴則通常需要反向強化的方式來解決，需要進行某些能夠避免戒斷症狀的行為才能緩和。[1][2]
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Quick Facts
| 「成癮及生理、心理倚賴」的相關術語詞彙表[1][2][3][4] |
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- 成癮：腦部失調的情形，特徵是會強迫性的接觸犒賞刺激，不去考慮其帶來的負面結果。
- 成癮行為：具有犒賞性及正向增強效應的行為
- 成癮藥物：具有犒賞性及正向增強效應的藥物
- 倚賴性：之前曾頻繁接觸刺激源（例如藥物攝取），中斷接觸後出現戒斷症狀的情形
- 藥物敏化或逆耐藥性：在固定藥物劑量的情形下重複給藥，而相同劑量的藥物效果增強的情形
- 藥物戒斷：在重複藥物使用後停藥，出現的症狀
- 生理倚賴：出現持續生理戒斷症狀（例如疲勞及震顫性譫妄）的倚賴性
- 心理倚賴：出現情緒或是精神戒斷症狀（例如煩躁及失樂）的倚賴性
- 增強刺激：特定類型的刺激，接觸後會增加再接觸此刺激的可能性
- 犒賞刺激：特定類型的刺激，大腦會認為此刺激是正向的，會想再進行的
- 敏化作用：重複接受某一刺激後產生的刺激增強性反應
- 物質使用疾患 ：使用特定物質，而且造成臨床上或是功能上的損傷或是困境的情形
- 藥物耐受性：重複接受某一藥物後產生的藥物降低性反應
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Glossary. Icahn School of Medicine. [2021-04-29]. Malenka RC, Nestler EJ, Hyman SE. Chapter 15: Reinforcement and Addictive Disorders. Sydor A, Brown RY (編). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 364–368. ISBN 9780071481274. The defining feature of addiction is compulsive, out-of-control drug use, despite negative consequences. ...
Addictive drugs are both rewarding and reinforcing. ... Familiar pharmacologic terms such as tolerance, dependence, and sensitization are useful in describing some of the time-dependent processes that underlie addiction. ...
Dependence is defined as an adaptive state that develops in response to repeated drug administration, and is unmasked during withdrawal, which occurs when drug taking stops. Dependence from long-term drug use may have both a somatic component, manifested by physical symptoms, and an emotional–motivation component, manifested by dysphoria. While physical dependence and withdrawal occur with some drugs of abuse (opiates, ethanol), these phenomena are not useful in the diagnosis of addiction because they do not occur with other drugs of abuse (cocaine, amphetamine) and can occur with many drugs that are not abused (propranolol, clonidine).
The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders (2000), which makes distinctions between drug use, abuse, and substance dependence, is flawed. First, diagnosis of drug use versus abuse can be arbitrary and reflect cultural norms, not medical phenomena. Second, the term substance dependence implies that dependence is the primary pharmacologic phenomenon underlying addiction, which is likely not true, as tolerance, sensitization, and learning and memory also play central roles. It is ironic and unfortunate that the Manual avoids use of the term addiction, which provides the best description of the clinical syndrome.
