Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views (2024)

Abstract

Keywords: Addiction, addictive behavior, prevention

INTRODUCTION

The concept of addiction is not easy to define and the usage of the term addiction has been considered as controversial;[2] however, central to its definition is the dependence on a substance or activity.[1]

Until recently, “non-substance related behavioral addiction” was listed in neither of the two internationally used diagnostic manuals of mental disorders, i.e. DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders)[1] and ICD-10 (International Classification of Disease).[3] Contrary to the commonly held belief that holds addiction to be a particular kind of dependence on drugs and chemical substances such alcohol, nicotine and heroin, behavior science experts believe that any source which is capable of stimulating an individual, could become addictive. The change of behaviors such as gambling, drug abuse, computer gaming or chatting and internet browsing from habits into obligatory behavior, can be considered as the development of addiction.[4]

The idea that true addictions can exist even in the absence of psychotropic drugs (behavioral addictions) was popularized by Peele.[4] According to Peele, addicted individuals are dependent on a particular set of experiences, of which the reactions to a specific chemical substance is only one example.

Building on Peele's notion, some authors have developed the idea that addiction does not necessarily have to involve the abuse of a chemical intoxicant or substance.[5,6]

For example, the term “addiction” has been used to refer to a range of excessive behaviors, such as gambling,[7] video game playing,[8,9] eating disorders,[10] sports and physical exercise,[11] media use,[12,13] sex addiction, pathological working,[14] and compulsive criminal behavior. Although such behavioral addictions do not involve a chemical intoxicant or substance, a group of researchers have posed that some core indicators of behavioral addiction are similar to those of chemical or substance addiction.[15] At present, researchers emphasize that in order to make a diagnosis of behavioral addiction, functional impairments must be present at work, in social relationships, or in other social situations.[16]

A number of experts believe that behavioral addictions can be passive (e.g. television) or active (e.g. computer games), and usually contain inducing and reinforcing features which may contribute to the promotion of addictive tendencies.[16]

Considering the importance of prior literature on behavioral addiction, the primary aim of this study was to review the major approaches expressed in this field.

METHODS

This is a descriptive study and content analysis. First, differences and similarities of different perspectives in the field of addiction as well as behavioral symptoms of addiction to various substances was obtained from scientific literature (1990-2009). Thereafter, the obtained data was coded and categorized and subjects were discussed and major issues were extracted.

DISCUSSION

A number of experts such as Brown have argued that the concept of addiction is meaningful and that is should not be restricted to the ingestion of substances.[28] the six criteria of Brown can be summarized as follows:

1. Salience: Domination of a person's life by the activity

2. Euphoria: A ‘buzz’ or a ‘high’ is derived from the activity

3. Tolerance: The activity has to be undertaken to a progressively greater extent to achieve the same ‘buzz’

4. Withdrawal Symptoms: Cessation of the activity leads to the occurrence of unpleasant emotions or physical effects

5. Conflict: The activity leads to conflict with others or self-conflict

6. Relapse and Reinstatement: Resumption of the activity with the same vigor subsequent to attempts to abstain, negative life consequences, and negligence of job, educational or career opportunities.[29,30]

From the psychological and psychiatric viewpoint, behavioral addictions include a collection of disorders, such as anxiety, depression, obsessive thoughts[31], withdrawal and isolationism, affective disorders, disturbances in social relationships, school problems such as educational failure and lack of interest in doing homework, occupational or interpersonal difficulties, isolation and negligence of friends and family or personal responsibilities, and mental or physical restlessness. In instances when the individual reduces or stops a specific behavior, excessive fatigue, lifestyle changes, significantly reduced physical activity, deprivation and changes in sleep patterns, impatience, sexual deviations, violence, eating disorder and withdrawal symptoms ensue.

Behavioral addiction risk factors have biological bases and some of them have been effectively treated by SSRIs.[31] Also, cognitive- behavioral therapy, which is the treatment of drug addiction disorders, emotional disorders and eating disorders could be useful.[32] In the treatment of behaviors such as drug addiction, four fundamental aspects should be considered: 1 – prior individual psychopathology 2 - differential reinforcement 3 – maladaptive cognitions 4 - Social support network. In this area psychiatrists and psychologists involved in the field of mental health should be aware of psychological problems caused by addictive behaviors, including symptoms such as anxiety, depression, aggression, and academic and career dissatisfaction.

CONCLUSION

Similar to substance abuse prevention programs aimed at addicted persons, specialized training can educate adolescents about the warning signs of online addiction in order to assist early detection.

1. Parents should inform their children about the negative consequences of overuse of the Internet and its moral deviations, in order to prevent addiction.

2. Parents should monitor their children while using internet and teach them the useful and appropriate methods of internet use. This helps adolescents self-monitor their online use without abusing it.

3. Behavior science professionals might help adolescents understand the factors underlying their online habits and reintegrate former activities into their lifestyles and aid to prevent suspected cases of online abuse.

4. It is important to know that prevention programs for online abuse can reduce the occurrence of future incidents and decrease risk of internet addiction.

5. One of the important ways to prevent internet addiction, is to treat risk factors such as loneliness, stress, depression and anxiety, which may trigger the addiction to the internet and should be treated. Mental health professionals should encourage individuals who overuse the internet, to seek treatment when problems emerge, and help them identify ways they may be using the internet to escape from real life.

6. Authorities and cultural institutions have a duty of providing healthy and proper usage of the internet to individuals, especially adolescents who are most vulnerable, via mass media education and training. Therefore, the most important step in this field is education and information

7. We should realize, however, that filtering is necessary and can limit the abuse of internet (using p*rnographic sites, etc) but it is temporary. In the current situation, the government must invest in immunization, strengthening of religious beliefs and improving the sprit. It seems that in such ways the correct usage of the internet in the community will be naturalized.

8. Much research must be done to show that educational training programs on internet addiction have proven effective in preventing new cases and improving the satisfaction and cohesion with internet using.

Footnotes

REFERENCES