Substance addition - more traditional idea of addiction to a substance that causes a physiological addiction (that’s not to say there aren’t behavioural elements). Often mind-altering substances.
Behavioural addiction - behaviours that impact the rewards centres of the brain, such as gambling, binge eating, sex, shopping, gaming, exercise, cosmetic surgery, watching porn, risky behaviours.
The current Diagnostic and Statistical Manual, 4th Edition (DSM-IV-TR) has designated formal diagnostic criteria for several of these disorders, classifying them as impulse control disorders, a separate category from substance use disorders. Other behaviors (or impulse control disorders) have been included in DSM-IV DSM – gambling, kleptomania, internet gaming disorder, internet addiction, food addiction, hypersexuality, shopping addiction, exercise addiction, and tanning addiction.
Behavioural addictions have more than tripled in the last decade while substance abuse has remained relatively stable over the last 20 years. This also correlates with the widespread use of social media (correlation not causation!)
Phones - one click on Amazon prime, a few clicks to online porn, a few clicks to takeaway orders, a few clicks to place an online bet…
Signs of behavioural addiction:
* Spending the majority of your time engaging in the behavior, thinking about or arranging to engage in the behavior, or recovering from the effects
* Becoming dependent on the behavior as a way to cope with emotions and to “feel normal”
* Continuing despite physical and/or mental harm
* Having trouble cutting back despite wanting to stop
* Neglecting work, school, or family to engage in the behavior more often
* Experiencing symptoms of withdrawal (for example, depression or irritability) when trying to stop
* Minimizing or hiding the extent of the problem
Gambling - Johnson & Dixon (2009) used a response cost to reduce gambling behaviours in pathological gamblers by getting the participants to pay to gamble (or have the dealer perform the response for free). Only partially successful. To me this makes sense. To gamble, you have to pay?!
Dixon, Marley & Jacobs (2003) found through multiple measures of delay discounting indicated that gamblers discounted delayed rewards (1 week later) more steeply than did control participants. SO maybe casinos/online gambling forums should deliver rewards one week/month/year later?
Interestingly, there have also been behavioural interventions for substance abuse disorders, such as alcoholism and heroin use published in JABA.
Personal use?
- Baseline data
- Social validity
- Determine intervention
- Take data
Ref:
Johnson, T.E. and Dixon, M.R. (2009), ALTERING RESPONSE CHAINS IN PATHOLOGICAL GAMBLERS USING A RESPONSE-COST PROCEDURE. Journal of Applied Behavior Analysis, 42: 735-740.
Dixon, M.R., Marley, J. and Jacobs, E.A. (2003), DELAY DISCOUNTING BY PATHOLOGICAL GAMBLERS. Journal of Applied Behavior Analysis, 36: 449-458.
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Disclaimer: While we’re both behaviour analysts and qualified in our respective fields, this podcast is for education and information sharing only and should not be taken as personal, medical or behavioral advice or services.