1 Overview of Behavioral Addictions
Learning Objectives
- Identify and describe theoretical framework and history of behavioral addiction.
- Describe the difference between substance use addiction and behavioral addiction.
- Utilize and research SAMHSA Guidelines for identification and treatment of behavioral addictions.
- Utilize DSM – 5 TR for diagnosis and research of criterion to treat behavioral addictions.
Overview of behavioral addictions
The introduction of behavioral addictions is a relatively new concept in psychology and psychiatry. It was not until 2010 that the term behavioral addictions was added to the official classification of psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth Edition. Gambling, technological advances, internet, smartphones, have become increasingly addictive, negatively impacting the mental and physical health of young adults and adolescents (Derevensky, Hayman, & Lynette, 2019).
A behavioral addiction, also known as a process addiction or non-substance-related addiction, is characterized by the compulsive engagement in a specific behavior despite negative consequences. Unlike substance addictions, which involve the use of drugs or alcohol, behavioral addictions revolve around activities that produce rewarding effects and can lead to a cycle of addiction. Behavioral addictions typically do not result in physical withdrawal symptoms, but can cause psychological distress when the addictive behavior is discontinued.
Characteristics of Behavioral Addiction
- Compulsion and Loss of Control
- The individual feels a strong urge or compulsion to engage in the behavior. For example, a person might engage in risky sexual behavior despite knowing that they are putting their bodies at risk of infection.
- There is a loss of control over the frequency, intensity, or duration of the behavior, the person may choose the addictive behavior over regular day to day tasks that are necessary for their survival and wellnesss.
- Continued Engagement Despite Harm
- The behavior continues even when it leads to negative consequences such as financial problems, relationship issues, or physical and mental health problems.
- Preoccupation
- The individual becomes preoccupied with the behavior, often thinking about it when not engaged in it and planning for the next opportunity. The person neglects all other areas of their lives in attempt to constantly engage either mentally or physically in the addictive behavior. Sometimes, in severe addiction, the person will settle for talking about the activity if they are unable to physically perform it. An example might be a person addicted to video games might talk about the video game to a friend if they are unable to play it.
- Tolerance and Escalation
- Over time, the individual may need to increase the frequency or intensity of the behavior to achieve the same level of satisfaction or relief.
- Withdrawal Symptoms
- The individual may experience emotional or psychological withdrawal symptoms, such as anxiety, irritability, or restlessness, when unable to engage in the behavior.
Common Types of Behavioral Addictions
Though any behavior can become addictive, and many maladaptive behaviors that are used to cope with stressors have been known to cause addiction, these are the most common behavioral addictions:
- Gambling Addiction
- Compulsive gambling that leads to significant financial losses, relationship issues, and other negative consequences.
- Internet Gaming Disorder
- Excessive and compulsive playing of video games, leading to impairment in daily life activities, including work, school, and relationships.
- Sex Addiction
- Engaging in excessive or compulsive sexual behaviors, often at the expense of personal well-being and relationships.
- Shopping Addiction (Compulsive Buying Disorder)
- Uncontrollable and frequent shopping sprees that result in financial problems and emotional distress.
- Food Addiction
- Compulsive overeating or binge eating, often associated with feelings of loss of control and significant distress.
- Exercise Addiction
- Compulsive engagement in physical exercise, often to the detriment of physical health and social relationships.
Causes and Risk Factors
- Psychological Factors: Stress, anxiety, depression, and other mental health issues can contribute to the development of behavioral addictions.
- Genetic Predisposition: There may be a genetic component that makes some individuals more susceptible to developing addictions.
- Environmental Factors: Exposure to environments that promote the addictive behavior, such as casinos or online gaming communities.
- Personality Traits: Traits such as impulsivity, sensation-seeking, and a high need for stimulation can increase the risk of behavioral addictions.
Treatment Approaches
- Cognitive-Behavioral Therapy (CBT)
- Helps individuals identify and change negative thought patterns and behaviors associated with the addiction.
- Motivational Interviewing (MI)
- Enhances the individual’s motivation to change by exploring and resolving ambivalence.
- 12-Step Programs
- Provides a structured support system and community for individuals seeking recovery from behavioral addictions.
- Family Therapy
- Involves family members in the treatment process to address relational issues and support the individual’s recovery.
- Mindfulness and Stress Management
- Techniques such as mindfulness meditation and stress management can help individuals cope with triggers and reduce compulsive behaviors.
Summary
Behavioral addictions share many similarities with substance addictions in terms of their compulsive nature and impact on brain reward systems. However, they involve behaviors rather than substances. Effective treatment often involves a combination of therapeutic approaches tailored to the individual’s specific needs and circumstances.
Key Differences Between Behavioral and Drug Addictions
Key Takeaways
Behavioral Addictions
- Definition: Compulsive engagement in non-substance-related activities despite negative consequences.
- Examples: Gambling addiction, internet gaming disorder, excessive time on social media, shopping addiction, sex addiction.
- Brain Mechanisms: Similar to drug addictions, involving stimulation of the brain’s the reward system with neurotransmitters like dopamine.
- Symptoms: Preoccupation with the behavior, inability to control the behavior, neglect of responsibilities, continued behavior despite harm.
- Treatment: Often involves behavioral therapies like CBT, MI, and sometimes inclusion of pharmacological interventions.
Drug Addictions
- Definition: Compulsive use of substances despite harmful consequences.
- Examples: Alcohol addiction, opioid addiction, cocaine addiction, nicotine addiction.
- Brain Mechanisms: Involves changes in brain structure and function, particularly in areas related to reward, memory, and decision-making.
- Symptoms: Physical dependence, tolerance, withdrawal symptoms, craving, neglect of responsibilities, continued use despite harm.
- Treatment: May include detoxification, medication-assisted treatment (MAT), behavioral therapies, and support groups.
Both types of addictions share similarities in their compulsive nature and impact on brain reward systems, but they differ in their manifestations and some aspects of their treatment approaches.
Supplemental video: Behavioral addiction vs. Substance addiction
https://woodlandcc.instructuremedia.com/embed/62c3c0fb-096c-44ee-beb8-ebdd4f2ae1b2
Reference
Derevensky JL, Hayman V, Lynette Gilbeau. Behavioral Addictions: Excessive Gambling, Gaming, Internet, and Smartphone Use Among Children and Adolescents. Pediatr Clin North Am. 2019 Dec;66(6):1163-1182. doi: 10.1016/j.pcl.2019.08.008. PMID: 31679605.
