Processes and Behavioral Addictions Flashcards
What is a process addiction?
repetitive, persistent behaviors, where there is an inability to stop despite the negative consequences
What makes process addictions ‘addictions’?
cravings, bingeing, tolerance, withdrawal
stimulation of endogenous chemicals
failure to control behavior regardless of adverse and catastrophic consequences
Pornography addiction (definition)
where the consumption of pornography (material describing or showing sexual acts and is meant to arousing to the viewer) may become harmful and compulsive
Why do people watch porn?
Enhance sexual arousal
learn about sex
loneliness
boredom
decrease shame about sex
confirm sexual orientation
How can porn be potentially helpful?
education
shame reduction
normalize homosexual/bisexual behavior
normalize personal behavior
stress reduction
Issues for young porn viewers
more frequent engagement in risky sex
experience sexually coercive partners
male adolescents who report regular porn use exhibit higher levels of aggression
Issues Arising as a result of pornography
miseducation
exploitation/abuse
physical issues
addiction
Subject who reported high exposure to pornography reported physical problems such as
pornography-induced erectile dysfunction
pornography-induced abnormally low libido
lower sexual responsibility with partners
increased need for more extremely specialized and “kinky” videos
Neurobiological underpinnings of porn addiction
Novelty; compelling because it creates increases in dopamine in regions of the brain associated with reward and goal-directed behavior
Salient Qualities of Internet Porn that Stimulate Dopamine
mesolimbic dopamine activity also nehanced by properties often associated with internet pornography
violation of expectations
anticipation of reward/anxiety
ICD-11 Compulsive Sexual Behavior Disorder Diagnostic Criteria
a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior manifested in one or more of the following:
- engaging in sexual behaviors has become a central focus of the individual’s life to the point of neglecting personal responsibilities
- numerous unsuccessful efforts to control or reduce behaviors
- continuing behaviors despite adverse consequences/no pleasure
Controversy regarding sex addiction
Some think its a myth; excuse for questionable moral behavior
could describe someone with a higher-than-average sex drive
Prevalence of sex addiction
Research suggests 1 in 25 people struggle with “sex addiction”
Varying presentation of sex addiction
some show characteristics of impulse control disorder
some exhibit sexual obsessions and compulsions like OCD
Similarities to OCD
obsessions - unsuccessful attempts to ignore or suppress
compulsions - driven to perform the compulsion to reduce the distress of obsession
impulsion - failure to resist
Common characteristics of Sex Addiction
emotional insecurity
low frustration tolerance
acting out behaviors
marital instability
anxiety
social isolation
underlying depression
85% are males
Characteristics of Sex Addicts
shame and depression
abusive and explotative behavior
Double-life in secracy
Appereance maintenance
Gambling Disorder DSM-5 definition
Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress
Gambling Disorder DSM-5 Criteria
- needs to gamble with increasing abouts of money to achieve desired excitement (tolerance)
- restless/irritable when attempting to cut down or stop (withdrawal)
- repeated unsuccessful efforts to control problem
How does gambling disorder present similarly to other addictions?
tolerance, withdrawal, cravings
Change in salience attribution
gambling as a coping mechanism
Pathological gambling is associated with
personality disorders
divorce
criminal offending to support gambling
suicidal ideation and attempts
alcohol misuse
Suicidality and Gambling Disorders
Suicidal ideation and suicide attempts are frequent in people with gambling disorder and are substantially greater than the general population
Are problem gamblers victims?
Casino industry prey on the addiction and lack of control problem gamblers have over their behavior
Offer incentives to customers even if they know they are problem gamblers
Heritability in Gambling Disorder
50% of total variance in gambling behavior is accounted for by genetics
Cognitive Distortions and Gambling DIsorder
Gambler’s Fallacy - belief that independent, past events influence independent, future occurrences
CBT for Gambling Disorder
focus on changing unhealthy gambling behavior and thoughts
teaches how to fight gambling urges and deal with uncomfortable emotions
Gambling Disorder is a disease because
people cannot control their behavior if the brain areas responsible for such behavior are biologically compromised
Why do people play video games?
Recreation
Achievement/competition
Sociability
Immersion
Avoid reality or coping
When does gaming become pathological?
Compulsive, preoccupation, cravings, negative consequences
Massively Multiplayer Online Games (MMO’s)
highest correlation with problem gambling
immersive, connection with other gamers, novelty, variable ratio reinforcement schedule
What is Gaming Addiction?
Attention bias
Salience Shift
Impaired Decision making
Clinical Presentation of Gaming Disorder
preoccupation wiwth gaming
withdrawal-like symptoms
tolerance
loss of other interests
used to cope/escape negative emotions
jeopardized relationship/ignoring responsibilities
Prevalence of Internet Gaming Across the World
Overall increase since COVID-19
Gaming curfews and restrictions in some countries
5% of adolescents around the globe
Neurobiological Mechanisms Underlying IGD
activation in brain regions associated with dopamine
reduced PFC activity related to impulse control and decision-making
reduced functional connectivity in networks involved with cognitive control, executive function, motivation, and reward
Attentional Bias in IGD Individuals
higher attention to addiction related stimuli (Stroop Color Test)
Common Negative Consequences of IGD
Neglect ADL’s
Loss of sleep
social isolation
family conflict
financial problems
Assessment of IGD
DSM or ICD
Quantitative Assessments
Structured Interviews
Treatment for IGD
residental treatment facilities
outpatient programs
psychoeducation
cognitive therapy
motivational interviewing
