Behavioral Addictions: Are they Really Addictions?
Post on 10-Jan-2016
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Behavioral Addictions:Behavioral Addictions:Are they Are they ReallyReally
Addictions?Addictions?
Thomas E. Legere, Ph.D.Thomas E. Legere, Ph.D.
How do we Decide?How do we Decide?
Old School: DSMOld School: DSM
We Need a We Need a NEWNEW Model! Model!
From From THREETHREE Sources… Sources…
Source #1: Source #1:
The DSMThe DSM
Source #2: Source #2: What Those Who What Those Who Suffer From the Suffer From the
Disease SayDisease Say
Source #3:Source #3:
NeurobiologyNeurobiology
Three Three TYPESTYPES of Addictions of Addictions
I. I. HARDHARD Addictions: Addictions: Alcohol & DrugsAlcohol & Drugs
II. II. SOFTSOFT Addictions: Addictions: Nicotine & CaffeineNicotine & Caffeine
III. III. BEHAVIORALBEHAVIORAL AddictionsAddictions
Three Three LevelsLevels of of
Addiction:Addiction:
• • MildMild
• • ModerateModerate
• • SevereSevere
Soft Addictions:Soft Addictions:““Soft” for a ReasonSoft” for a Reason
Proposed Proposed Behavioral Addictions:Behavioral Addictions:
• • SexSex• • LoveLove• • GamblingGambling• • ExerciseExercise• • EatingEating
What Makes them What Makes them “Real” “Real”
Addictions Addictions (or (or notnot)?)?
Need Need CommonCommon Criteria Criteria for for
HardHard Addictions & Addictions & BehavioralBehavioral Addictions Addictions
Honestly: Honestly: The DSM is Not The DSM is Not
Buying BehavioralBuying BehavioralAddictionsAddictions
DSM: DSM:
• • Compulsive DisordersCompulsive Disorders
• • Pathological BehaviorPathological Behavior
• • Eating DisordersEating Disorders
Twelve Integrated Twelve Integrated CriteriaCriteria
(DSM, Experience,(DSM, Experience,Neurobiology)Neurobiology)
1. 1. “Pleasure Pathway”“Pleasure Pathway”In the BrainIn the Brain
2. 2. Same BrainSame BrainChemicals InvolvedChemicals Involved
• • DopamineDopamine • • GabaGaba• • Serotonin Serotonin • • GlutamateGlutamate• • EndorphinsEndorphins • • CortisoneCortisone• • Norepinephrine Norepinephrine • • CorticotrophinCorticotrophin• • EpinephrineEpinephrine • • HistamineHistamine• • EnkephalinsEnkephalins • • AnandamideAnandamide• • AcetylcholineAcetylcholine
3. 3. ToleranceTolerance
4. 4. Use to “Intoxication”:Use to “Intoxication”:““I Can’t Stop!”I Can’t Stop!”
5. 5. Obsessive DimensionObsessive Dimension
6. 6. DenialDenial
7. 7. Continued Use Continued Use DespiteDespite
Adverse ConsequencesAdverse Consequences
8. 8. Progressive Progressive Escalation Escalation
of “Intake” and of “Intake” and ProblemsProblems
9. 9. Repeated Attempts Repeated Attempts To Control UseTo Control Use
10. 10. WithdrawalWithdrawal
11. 11. IncurableIncurable(Only Remission)(Only Remission)
12. 12. Effectiveness ofEffectiveness of12 Step Program12 Step Program
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