Behavioral addiction is a form of addiction which does not rely on drugs or alcohol. Increasingly referred to as process addiction[1] or non-substance-related addiction [2][3]) behavioral addiction includes a compulsion to repeatedly engage in an action until said action causes serious negative consequences to the person's physical, mental, social, and/or financial well-being.[4][5] One sign that a behavior has become addictive is if it persists despite these consequences.
The type of behaviors which some people have identified as being addictive include gambling, food, sex, viewing of pornography, use of computers, playing video games, use of the internet, work, exercise, spiritual obsession (as opposed to religious devotion), pain [6], cutting and shopping.
When analyzing the addiction to food for example, a published study in 2009 from The Scripps Research Institute have shown for the first time that the same molecular mechanisms that drive people into drug addiction are behind the compulsion to overeat, pushing people into obesity. In this study, scientists focused on a particular receptor in the brain known to play an important role in vulnerability to drug addiction -- the dopamine D2 receptor. The D2 receptor responds to dopamine, a neurotransmitter that is released in the brain by pleasurable experiences like food or sex or drugs like cocaine [7].
Behavioral addictions has been proposed as a new class in DSM-5, but the only category included is gambling addiction. Internet addiction and sex addiction are included in the appendix.[8]
The term soft addiction was coined by Judith Sewell Wright to describe activities, moods or ways of being, avoidances, and things-edible and consumable but which do not pose a grave health disease risk - rather, they have the most effect on personal time and productivity. [9][10] These behaviors were profiled in a 2007 ABC News story titled Bad Habits.[11]
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There is disagreement as to the exact nature of behavioral addiction or dependency. [12] However, the biopsychosocial model is generally accepted in scientific fields as the most comprehensive model for addiction. Historically, addiction has been defined with regard solely to psychoactive substances (for example alcohol, tobacco and other drugs) which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain. However, "studies on phenomenology, family history, and response to treatment suggest that intermittent explosive disorder, kleptomania, problem gambling, pyromania, and trichotillomania may be related to mood disorders, alcohol and psychoactive substance abuse, and anxiety disorders (especially obsessive–compulsive disorder)."[13]
In the case of pathological gambling, for example, the American Psychological Association classifies the condition as an impulse control disorder and not an addiction.[14]
There are many similarities in the neurobiology of behavior and drug addictions. One of the most important discoveries of addictions has been the drug based reinforcement and, even more important, reward based learning processes. Several structures of the brain are important in the conditioning process of behavior addiction. One of the major areas of study includes the region, called the amygdala, which involves emotional significance and associated learning. Research shows that dopaminergic projections to the amygdala facilitate a motivational or learned association to a specific behavior. [15] The cycle that is created is considered the dopamine reward system.
Dopamine neurons take a role in the learning and sustaining of many of the behaviors we acquire. Research specific to Parkinson’s disease has led to identifying the intracellular signaling pathways that underlie the immediate actions of dopamine. The most common mechanism of dopamine is to create addictive properties along with certain behaviors. [16] There are three stages to the dopamine reward system: bursts of dopamine, triggering of behavior, and further impact to the behavior. Once electronically signaled, possibly through the behavior, dopamine neurons let out a ‘burst-fire’ of elements to stimulate areas along fast transmitting pathways. The behavior response then perpetuates the striated neurons to further send stimuli. The fast firing of dopamine neurons can be monitored over time by evaluating the amount of extracellular concentrations of dopamine through micro dialysis and brain imaging. This monitoring can lead to a model in which one can see the multiplicity of triggering over a period of time. [17] Once the behavior is triggered, it is hard to work away from the dopamine reward system.
Behaviors like gambling have been linked to the new found idea of the brain’s capacity to predict rewards. The reward system can be triggered by early detectors of the behavior, and trigger dopamine neurons to begin stimulating behaviors. But in some cases, it can lead to many issues due to error, or reward-prediction errors. These errors can act as teaching signals to create a complex behavior task over time. [17]
It is estimated that at least 90% of Americans have at least one form of soft addiction in their lives. Nadine Kaslow, PhD, professor of psychology and behavioral sciences at Emory University in Atlanta, has commented on the issue, saying that while it is healthy to relieve stress with behaviors like drinking coffee and watching television, when they become habitual they become problematic to one's health and happiness.[18]
Cyber-psychologist Kimberly Young, director of the Center for Online Addiction, has addressed Internet addiction, one of the most common types of "soft addictions". Young has likened excessive Internet use to pathological gambling.[19]
Research around addictions and social media sites has been growing. The Retrevo company recently came out with research suggesting that there is an obsessiveness to the way people are checking their pages.[20]
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