Notre travail offre une analyse critique des principales théories explicatives de l’addiction articulée autour d’une distinction entre les théories médicales de l’addiction et les explications qui relèvent d’une approche morale (notamment l’explication acratique). Les secondes s’opposant aux premières essentiellement par l’idée que l’individu conserve dans l’addiction sa liberté d’agir autrement. Ces deux types de théories partagent cependant un présupposé commun : une condition pathologique serait incompatible avec une conduite volontaire et intentionnelle. Or certains éléments mis en avant par l’approche clinique de l’addiction, comme le sentiment d’ambivalence, l’initiation ou le phénomène du rétablissement spontané, obligent à remettre en cause un tel présupposé et à tenter d’échapper aux explications unilatérales de ce que nous proposons de qualifier philosophiquement de phénomène d’impuissance de la volonté. Il est en effet selon nous possible d’appréhender l’addiction à la fois selon une certaine forme de perspective morale et selon une certaine forme de perspective pathologique. En premier lieu (cf. Partie 1) parce que l’opposition entre approche acratique et approche pathologique compulsive cérébrale ne repose que sur une certaine idée de la compulsion qui peut et doit être remise en cause. En second lieu (cf Partie 2) parce que le concept de maladie qui sous-tend également cette opposition est lui aussi critiquable et qu’il convient de penser l’addiction à la lumière d’une notion de pathologie plus souple, permettant d’intégrer certaines marques de l’agentivité et de l’action volontaire. En troisième lieu, enfin (cf. Partie 3), parce que ce que l’on a appelé « les maladies de la volonté » offrent un modèle heuristique qui permet de redéfinir d’une manière plus appropriée le phénomène général l’impuissance de la volonté, grâce tout à la fois à l’idée de division interne à la volonté-même et à l’octroi d’un rôle central à l’obsession. Nous proposons donc à partir de notre enquête critique de repenser l’addiction comme une conduite obéissant à quelque chose que nous voulons et ne voulons pas de façon simultanée, au sens où nous avons des raisons simultanées de la poursuivre et de ne pas la poursuivre. Et de considérer que sa dimension pathologique vient de ce qu’une force interne s’y trouve bien introduite, mais dont la nature diffère de celle que désigne la notion dominante de compulsion. Car l’irrésistibilité à laquelle elle renvoie ne réside pas dans les actes, mais dans les pensées des agents. / This dissertation presents a critical analysis of the main explanatory theories on addiction structured around the distinction between the medical theories of addiction and explanations pertaining to a moral approach (namely, the acratic explanation). The latter set against the former primarily due to the idea that when addicted the individual retains the freedom to act differently. However, these two kinds of theories share a common assumption: a pathological condition would be incompatible with voluntary and intentional behavior. Yet, some components highlighted by a clinical approach – such as ambivalence, initiation or the “maturing-out” phenomenon – compel us to reconsider this assumption and to try and escape from unilateral explanations of what I propose to philosophically call “a phenomenon of powerlessness of the will”. Indeed, this dissertation argues that addiction can be understood both trough moral and pathological perspectives. Firstly (cf. part 1) because the opposition between the acratic approach and the pathological compulsive cerebral approach only rests upon a specific definition of compulsion, which can and must be called into question. Secondly (cf. part 2) because the concept of disease which is inherent to this opposition is open to criticism and addiction could be reconsidered in light of a more flexible disease theory, allowing for the integration of certain signs of agency and voluntary action. And finally, in a third part (cf. part 3), because the previously defined concept of the “diseases of the will” presents a heuristic model through which to redefine the general phenomenon of powerlessness of will. This is due both to the idea of internal division of the will and to the main part granted to obsession. Through a critical analysis, this dissertation thus strives to rethink addiction as a behavior subjected simultaneously to what we want and what we don’t want, insofar as we have simultaneous reasons to act and not act on this will. To conclude, the pathological dimension of addiction comes from the introduction of an internal force, whose nature is, however, not referred to in the classical concept of compulsion. The irresistibility to which it pertains does not lie in people’s behaviors but in their thoughts.

Maged1 appartient à la famille des gènes Mage (pour Melanoma antigen gene). Bien que les gènes Mage aient tout d'abord été découverts dans des cellules tumorales, le gène Maged1 est également exprimé dans un grand nombre de tissus sains et particulièrement dans le système nerveux central, aussi bien au cours du développement que chez l'animal adulte. Les fonctions exercées par la protéine Maged1 dans le système nerveux restent actuellement fort méconnues bien que des études aient pu mettre en évidence son implication dans des processus tels que l'homéostasie du rythme circadien, certaines formes d'apprentissages, les comportements sociaux et sexuels ainsi que dans des pathologies telles que la dépression et l'obésité. Au laboratoire, nous avons pu montrer que la délétion de l'allèle Maged1 chez la souris cause une diminution d'activité locomotrice spontanée et un déficit de coordination motrice. Les animaux ne possédant plus l'allèle Maged1 montrent également une absence complète de réponse à l’administration de drogues comme la cocaïne et la morphine. Au cours de ce travail de thèse, nous avons recherché les mécanismes liant le gène Maged1 et ces comportements. La dopamine étant un neurotransmetteur connu pour réguler à la fois les comportements moteurs et les comportements liés à la dépendance aux drogues, nous avons tout d'abord fait l'hypothèse qu'un déficit en dopamine pouvait expliquer les phénotypes observés. En effet, des expériences de microdialyse in vivo ont montré que l'augmentation de concentration en dopamine dans le nucleus accumbens suite à une injection de cocaïne était significativement réduite chez les souris dépourvues de l'allèle Maged1. L'implication directe de Maged1 dans la physiologie des neurones dopaminergiques a été étudiée par la génération de souris transgéniques dont la délétion du gène Maged1 a été ciblée spécifiquement dans ces neurones. Cependant, cette lignée de souris ne récapitule pas les phénotypes observés chez les souris entièrement dépourvues de l'allèle Maged1. Ces résultats indiquent que l'expression de Maged1 dans les neurones dopaminergiques n'est pas nécessaire au contrôle moteur et à la réponse comportementale à l'administration de cocaïne. Nous avons ensuite étudié les régions innervées par les neurones dopaminergiques en réalisant des enregistrements électrophysiologiques sur tranches de cerveaux en survie. Nous avons ainsi pu mettre en évidence une altération de la transmission glutamatergique entre le cortex préfrontal et le nucleus accumbens chez les souris dépourvues du gène Maged1. La délétion spécifique de l'allèle Maged1 dans chacune de ces deux régions a ensuite été effectuée. Les souris dont la délétion de Maged1 a été ciblée dans les neurones du striatum n'ont pas montré d'altération comportementales. Cependant, lorsque la délétion de Maged1 est effectuée spécifiquement dans le cortex préfrontal, les souris montrent un déficit d'apprentissage moteur ainsi qu'une réduction de l'effet de sensibilisation à des injections répétées de cocaïne. Chez ces mêmes souris, la réduction de sensibilisation est accompagnée d'une réduction de la réponse dopaminergique à la cocaïne telle qu'observée au cours d' expériences de microdialyse in vivo. Au cours de ce travail, nous avons donc pu montrer que la présence de la protéine Maged1 dans le cortex préfrontal est nécessaire à l'apprentissage moteur et à l'expression de la sensibilisation comportementale à la cocaïne. Cette protéine exerce probablement sa fonction en régulant la neurotransmission au niveau du compartiment présynaptique. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

[pt] Neste trabalho parte-se da concepção de que o sujeito e seus sintomas se constituem no seio de fatores pulsionais e socioculturais que promovem o laço social. Em seguida, delineia-se o perfil sócio-histórico da modernidade e da contemporaneidade, propondo-se que ambas constituem laços sociais diferentes, respectivamente centrados nos imperativos da interdição e da satisfação. Por último, argumenta-se que o imperativo da satisfação favorece a expansão do sintoma da toxicomania, que pode ser compreendido, tal como o laço social contemporâneo, pelo modelo da perversão. / [en] This work is based on the idea that the individual and his symptoms are constituted in the realm of libidinal and social-cultural factors that promote the social bond. At first, the social-historic profile of modernity and contemporary society are delineated, suggesting that both constitute different social bonds, respectively centered on the imperative of interdiction and the imperative of satisfaction. Next and finally, it is argued that the imperative of satisfaction favors the expansion of drug addiction, which can be explained, as well as the current social bond, by the model of perversion.

Magister Psychologiae - MPsych / Substance abuse is a global epidemic which is internationally recognised as an illness, characterised as being primary, chronic, progressive and terminal. Methamphetamine in South Africa is now drawing the interest of younger first time drug users from as young as thirteen years old, who are presenting at various rehabilitation centres in Cape Town. Many of the low socio-economic status areas are afflicted communities in Cape Town, which has been recognised by the Provincial government as an area troubled with societal concerns such as poverty, risky behaviour while using drugs or alcohol, violence and social disintegration. This qualitative study has its focus on the community leaders‟ perceptions of risk factors contributing to the spread of methamphetamine addiction in Manenberg and Lamberts Bay. The stigma attached to this area is often one that paints the portrait of a crime-ridden, desolate and poor community. The aim is to identify which risk factors community leaders believe are contributing to the increase of methamphetamine addiction in the area. Bronfenbrenner's social-ecological systems approach will act as a framework for this research study as well as utilising thematic analysis. It provides an understanding by which various systems within a community function and mutually co-operate. This allows one to expand on connotations ingrained in data collected from study participants.

Made available in DSpace on 2017-06-01T18:08:21Z (GMT). No. of bitstreams: 1 Eugenia Chaves.pdf: 1729965 bytes, checksum: 48ab84740ead0c769aeb7d5219756d5d (MD5) Previous issue date: 2006-04-28 / The objective of this present study is to give a little contribution to the answer that the psychoanalytic clinic is asked to give to the matter of drug addiction and its treatment. It is indeed a theoretical research, whose two main parts are linked to the matters of drug dependence and psychoanalytic transference. The theoretical reflections were clarified with the testimonies of some psychoanalysts that deaI. with drug dependants. On the part we tried to understand, through some fundamental references of the Freudian Meta psychology, the main characteristics of the psychic and pulsing life of the drug addict. On the second part, we dedicated to the problem of the psychoanalytical treatment of those patients, we tried to raise the problem of some specific aspects that present themselves as obstacles or possibilities for the constitution of a transferential field and the handling necessary for lhe creation of a analytic field, where the drug addict may be guarded and heard so as to be given an analytic treatment. The second part was algo divided into two chapters, the first one deals with the trajectory that Freud went through for a theoretical elaboration of the psychoanalytical concept of the transference thus showing its central importance in the analysis. The second one deals with the clinical news that drug addiction represents and the various problems that it raises; the arrival of the drug dependent to the analyst, his demands -that are not generally related to analysis -and the attitude in which these patients have the tendency of placing the analyst -We still make a reference to the complexity of the multiple transferences inherent to the institutional treatment an to the new challenge that they represent to the psychoanalytical clinic / O presente trabalho tem como objetivo trazer uma pequena contribuição à resposta que a clínica psicanalítica vem sendo solicitada a dar para a questão da toxicomania e do seu tratamento. Trata-se, pois, de uma pesquisa fundamentalmente teórica, cujas duas grandes partes articulam os temas da Toxicomania e da Transferência psicanalítica. As reflexões teóricas foram ilustradas com os testemunhos de alguns psicanalistas que lidam com toxicômanos. Na primeira parte, buscou-se compreender, mediante algumas referências fundamentais da Metapsicologia freudiana, as principais características da vida psíquica e pulsional do toxicômano. Na segunda parte, dedicada ao problema do tratamento psicanalítico desses pacientes, procurou-se problematizar alguns aspectos específicos, que se apresentam como obstáculos e/ou possibilidades para a constituição de um campo transferencial e os manejos que se fazem necessários para a criação de um espaço analítico, onde possa o toxicômano ser acolhido e escutado em vista de um tratamento analítico. A segunda parte, por sua vez, foi dividida em dois capítulos, o primeiro dos quais aborda a trajetória percorrida por Freud para a elaboração teórica do conceito psicanalítico de transferência, mostrando sua central importância na análise. O segundo trata da novidade clínica que a toxicomania representa e as diversas questões que levanta: a chegada do toxicômano ao analista, suas demandas que geralmente não são de análise , e a posição em que esses pacientes tendem a colocar o analista. Faz-se, ainda, uma referência à complexidade das transferências múltiplas, próprias do tratamento institucional, e ao novo desafio que elas representam para a clínica psicanalítica

La présente recherche porte sur quelques contingences et destins de la libido unique des sujets concernés par notre étude et appelés couramment « toxicomanes ». La fonction de la drogue est parfois sujette à des bouleversements dans des conjonctures très précises que l’on peut bien appeler « contingentes ». En psychanalyse, la contingence est articulée au régime de la nécessité. Ces diverses conjonctures vont marquer un avant et un après inoubliable dans la vie du sujet. Ce sont des moments où une pratique de jouissance et une position narcissique inhérente à cette pratique commencent à être questionnées par le sujet. Rencontres traumatiques avec le réel de la sexualité et/ou la mort à partir desquelles il y a une remise en question des repères habituels de quelqu’un qui se prétendait un « in-dividu ». Cela nous montre que si les toxicomanies sont une préférence accordée à une certitude de jouissance-Toute, une préférence contre un désir ou contre une jouissance sexuelle, elle n’est pas définitive et fermée dans tous les cas. Il y a un reste de la sexualité qui résiste à toute guérison (un « a ») et dont le retour et l’insistance peut à des moments singuliers perturber l’économie libidinale d’un sujet toxicomane. Un reste dont un sujet peut tirer profit lors d’un traumatisme, par exemple, afin de se mettre au travail ou au moins pour qu’il nous adresse une souffrance qui l’interpellait avant le début de sa consommation. Bien que l’occasion soit contingente, sortir d’une toxicomanie par le biais d’un symptôme entendu comme une possible solution singulière reste une initiative du sujet qui portera la marque de la structure clinique. Il y a un remaniement des repères temporels du sujet d’une part, et un passage par l’affect de l’angoisse ou la honte d’autre part. Ces deux affects peuvent être des boussoles dans une cure, ainsi que des effets d’une destitution d’un narcissisme et d’une présence du signifiant dans le réel du corps et du langage. Une présence qui se fait de plus en plus évidente et indéniable, et qui mènera le sujet à s’adresser à quelqu’un qui prenne en compte le plus singulier de sa souffrance. Cette écoute est susceptible de mettre en place un transfert sur quelqu’un qui n’est pas un alchimiste mais quelqu’un qui, au contraire, apporte son manque. / The present investigation addresses certain contingencies and destinies of the subjects that were the object of this study, who are commonly referred to as "drug addicts". The function of the drug can, at times, be transformed in the context of precise conjunctures which we may characterize as "contingent”. In psychoanalysis, contingency is linked to the regime of necessity. These diverse conjunctures mark an unforgettable before and after in the life of a subject. They are moments where a practice of enjoyment is ruined and a narcissistic position begins to be questioned by the subject, traumatic encounters with the reality of sexuality and death, from which arises a questioning of the usual points of reference of someone who considered themselves an "individual". This shows us that if drug addictions are a preference for a certainty of total enjoyment, a preference against desire and against sexual enjoyment, it is not definitive and closed in all cases. There is a remnant of sexuality that resists any cure and whose return and insistence can at certain times disturb the libidinal economy of a drug addict subject. A remnant of which he can extract a benefit in the context of a trauma, to get to work or at least to direct us a suffering that had been questioning him for a long time, before his first consumption. Although the occasion is contingent, leaving a practice of drug addiction by way of a symptom, understood as a possible singular solution, is an initiative of a subject that will have the stamp of the clinical structure. There is a restructuring of the temporal references of the subject on the one hand, and a passage for the feeling of anguish or shame on the other hand. These two feelings can be guides in a cure, as well as the effects of destitution of a narcissism and a presence of the signifier in the real of the body and language. A presence that is becoming more and more inevitable and that will lead the subject to address someone who takes into account the most unique aspect of their suffering. This listening is susceptible to generate a transfer in someone who is not an alchemist, but someone who is able to put his fault in play for those who consult it. / La presente investigación trata acerca de ciertas contingencias y destinos singulares de los sujetos que fueron objeto de este estudio y que comúnmente se los denomina “toxicómanos”. La función de la droga puede estar, a veces, sujeta a transformaciones en el marco de coyunturas precisas que podemos caracterizar como “contingentes”. En psicoanálisis, la contingencia está ligada al régimen de la necesidad. Estas coyunturas diversas marcan un antes y un después inolvidable en la vida de un sujeto. Son momentos donde una práctica de goce se arruina y una posición narcisista comienza a ser puesta en cuestión por parte del sujeto. Rencuentros traumáticos con lo real de la sexualidad y de la muerte, a partir de los cuales surge un cuestionamiento de los puntos de referencia habituales de alguien que se tomaba por un “in-dividuo”. Lo que nos muestra que si las toxicomanías son una preferencia por una certeza de goce-Todo, una preferencia contra el deseo y contra el goce sexual, ella no es definitiva y cerrada en todos los casos. Hay un resto (a) de la sexualidad que resiste a toda cura y cuyo retorno e insistencia puede en ciertos momentos perturbar la economía libidinal de un sujeto toxicómano. Un resto del cual él puede extraer un beneficio en el marco de un traumatismo, para ponerse a trabajar o al menos para que nos dirija un sufrimiento que lo interpelaba hacía tiempo, antes de su primer consumo. Si bien la ocasión es contingente, salir de una práctica de toxicomanía por la vía de un síntoma entendido como una posible solución singular, es una iniciativa de un sujeto que tendrá el sello de la estructura clínica. Hay una reestructuración de las referencias temporales del sujeto por un lado, y un pasaje por el afecto de la angustia o de la vergüenza por otro lado. Estos dos afectos pueden ser orientadores en una cura, así como los efectos de destitución de un narcisismo y de una presencia del significante en lo real del cuerpo y del lenguaje. Una presencia que se hace cada vez más inevitable y que llevará al sujeto a dirigirse a alguien que tome en cuenta lo más singular de su sufrimiento. Esta escucha es susceptible de generar una transferencia en alguien que no es un alquimista, sino alguien que es capaz de poner en juego su falta para quien lo consulta.

abstract: Intermittent social defeat stress induces psychostimulant cross-sensitization, as well as long-lasting social avoidance behavior. Previous data reveal heightened expression of AMPA receptor (AMPAR) GluA1 subunits in rat ventral tegmental area (VTA), which occurs concurrently with social stress-induced amphetamine (AMPH) cross-sensitization. These studies described herein examined whether VTA GluA1 AMPARs are important for the behavioral consequences of social stress and investigated the role of the infralimbic (IL) to VTA pathway in the induction of these responses. Functional inactivation of GluA1 in VTA DA neurons prevented stress-induced AMPH sensitization without affecting social avoidance behavior, while GluA1 overexpression in VTA DA neurons mimicked the effects of stress on AMPH sensitization. Female rats were more sensitive to the effects of stress on AMPH administration than males, specifically during proestrus/estrus, which is characterized by higher circulating estradiol. Fluorescent immunohistochemistry revealed that females expressed higher GluA1 in VTA DA neurons as a result of intermittent social defeat stress, independent of estrus stage; by contrast, females during proestrus/estrus displayed higher tyrosine kinase receptor type 2 (TrkB) expression, which is the receptor for brain derived neurotrophic factor (BDNF), in VTA DA neurons, independent of stress exposure. Functional inactivation of GluA1 in VTA DA neurons prevented stress-induced AMPH sensitization and overexpression mimicked the effects of stress on AMPH sensitization. This suggests that BDNF-TrkB signaling may work concomitantly with GluA1 signaling in the VTA to drive sex-dependent differences in stress-induced locomotor sensitization effects. Optogenetic inhibition of the IL-VTA pathway in male rats prevented stress-induced AMPH sensitization compared to control animals. In addition, fluorescent immunohistochemistry displayed less Fos labeling in the nucleus accumbens (NAc) of rats with IL-VTA light inhibition compared to control animals. This suggests that the IL-VTA pathway plays a critical role in the induction of stress-induced sensitivity to AMPH, and blocking this pathway prevents mesolimbic DA signaling to the NAc. We conclude that IL glutamate projections onto GluA1-homomeric AMPA receptors in VTA DA neurons play a critical role in driving the stress-induced sensitization response in males and females. Therefore, GluA1 VTA DA neurons could potentially be a therapeutic target to prevent stress-induced drug susceptibility in the future. / Dissertation/Thesis / Doctoral Dissertation Neuroscience 2020

Animals respond to changes in the environment and internal states to modify their behavior. The basal ganglia, including the striatum contribute to action selection by integrating sensory, motor and reward information. Therefore, dysregulation of striatal function is common in many neuropsychiatric disorders, including Parkinson’s disease, Huntington disease, schizophrenia, and addiction. Here, using fiber photometry, pharmacology, and behavioral approaches in transgenic mice, I explored the cellular and circuit mechanisms underlying key striatal functions. In Chapter 1, I begin by presenting the existing literature on the anatomy and physiology of the striatum. Next, I review the important functions of the striatum. Within this general review, I highlight the specific roles that striatal (DA) and acetylcholine (ACh) play in striatal circuitry and function. In Chapter 2, I demonstrate the naturally evoked ACh dip has a DA component and a non-DA component. Specifically, I show that DA via cholinergic DA D2 receptors (D2Rs) modulate the length of the ACh dip and rebound ACh levels following the dip. In addition, I show that DA coordinates the activity between DA and ACh during behavior. Finally, I present data that supports a role for ACh in motivated behavior. In Chapter 3, I show that cholinergic D2Rs are not necessary for reward learning but do facilitate reversal learning in a probabilistic choice task. In addition, I show that changes in DA and ACh levels contribute to reversal learning in a probabilistic choice task. Finally, in Chapter 4, I discuss the general conclusions and study implications, as well as future directions.

[pt] O uso de substâncias psicoativas sempre esteve presente na sociedade (de forma recreativa, terapêutica ou religiosa). A dependência em relação a essas substâncias, por sua vez, tem ocupado cada vez mais espaço na mídia e em discussões político-sociais que buscam entender o fenômeno. Questões culturais, sociais, econômicas, farmacológicas e psíquicas devem ser consideradas quando se propõem teorias e ações de tratamento. Esse trabalho investiga as principais concepções teóricas acerca das toxicomanias no campo da psicanálise e analisa seus percursos teóricos. Destaca os principais conceitos que embasam as teorias, apura as divergências e convergências e verifica a evolução destas a partir do surgimento de novas perspectivas e da influência do contexto social contemporâneo a elas. Para melhor compreensão do contexto no qual essas teorias foram elaboradas, foi feito um levantamento da história do uso de drogas e do tratamento dos toxicômanos ao longo da história. Em seguida, investigou-se as principais concepções teóricas no campo da psicanálise através de um mapeamento de obras de autores clássicos e contemporâneos. Destacou-se e analisou-se os principais conceitos-base para as teorias encontradas. Como resultado, identificou-se alguns eixos teóricos, que partem do narcisismo, identificação, destrutividade, compulsão à repetição e relações objetais. Também observou-se variações no estatuto psicopatológico, classificado como sintoma, estrutura, quadro, dentre outros. Por fim, constata-se que, apesar das divergências existentes, o recurso aos tóxicos predomina enquanto uma tentativa de remediar uma angústia, ainda que tenha consequências nocivas. / [en] The use of psychoactive substances has always been present in society (in a recreational, therapeutic or religious way). The addiction to these substances, in turn, has been more and more present in the media and in political-social discussions that try to understand the phenomenon. Cultural, social, economic, pharmacological and psychological aspects must be considered when theories and treatment actions are proposed. This work investigates the main theoretical conceptions about drug addictions in the psychoanalysis field. It also analyzes their theoretical paths. It highlights the main concepts that underlie the theories, refines divergences and convergences, verifies their evolution from the emergence of new perspectives and verifies the influence of the social context to them. In order to understand the context in which these theories were elaborated, a survey of the history of drug use and treatment of drug addicts was made throughout history. Moreover, the main theoretical concepts in psychoanalysis were investigated through a bibliographical analysis of works in both classic and contemporary authors. The main basic concepts for the theories found were highlighted and analyzed. As a result, some theoretical biases were identified, from narcissism, identification, destructiveness, repetition compulsion and object relations, for instance. There were also variations in psychopathological status, classified as symptom, structure, condition, among others. Finally, it was noted that despite the disagreements, the use of toxic substances predominates as an attempt to relieve anguish, even if the psychotropic medication has harmful consequences.

No description available.