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TRYING to articulate diagnostic criteria, behaviors, and characteristics common to different kinds of addictions has proven challenging. Smith has summarized a variety of these as follows:
Adapted from: Smith, Treatment Strategies for Substance and Process Addictions, American Counseling Association, Alexandria VA, 2015)
THE following list of diagnostic criteria for process disorders (behavioral addictions) represents an adaptation of criteria found in the DSM5 for substance related disorders and gambling addiction
[p.7] TABLE 1.1 DIAGNOSTIC CRITERIA FOR ASSESSING PROCESS DISORDERS
A persistent and recurrent problematic behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:
1. Needs to increase the frequency of the behavior in order to achieve the desired excitement.
2. Is restless or irritable when attempting to cut down on the behavior..
3. Has made repeated unsuccessful efforts to control, cut back, or stop the behavior.
4. Is often preoccupied with the behavior (e.g, has persistent thoughts of reliving past experiences, handicapping or planning the next venture, thinking of a way to partake in the behavior).
5. Often engages in the behavior when feeling distressed (e.g., helpless, guilty, anxious, depressed).
6. After unsuccessfully reaching an anticipated high when participating in the behavior, tries riskier scenarios when using the behavior.
7. Lies to conceal the extent of involvement with the behavior.
8. Has jeopardized or lost a significant relationship, job, or educational or career opportunities by repeating the behavior.
9. Relies on others to minimize the consequences of the repeated behavior.
Note. Adapted from Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (p. 585), by American Psychiatric Association, 2013
[pp. 7-8] ASAM (2011) identified several behaviors, and subsequent consequences that are associated with an addiction:
[1] Excessive use of and/or engagement in addictive behaviors, at higher frequencies and/or quantities than the person intended, often associated with a persistent desire for and unsuccessful attempts at behavioral control
[2] Excessive time lost in substance use or recovering from the effects of sub stance use and/or engagement in addictive behaviors, with significant adverse impact on social and occupational functioning (e.g., the development of interpersonal relationship problems or the neglect of responsibilities at home, school, or work)
[3] Continued use and/or engagement in addictive behaviors despite the presence of persistent or recurrent physical or psychological problems that may have been caused or exacerbated by substance use and/or related addictive behaviors
[4] A narrowing of the behavioral repertoire focusing on rewards that are part of addiction
[5] An apparent lack of ability and/or readiness to take consistent, ameliorative action despite the recognition of problems
[p.9] Engs. (2012) noted the following common characteristics of an addict:
1. The person becomes obsessed with (constantly thinks: of) the object, activity, or substance.
2. The person will seek it out or engage in the behavior even though it is causing harm (physical problems; poor work or study performance; problems with friends, family, fellow workers).
3. The person will compulsively engage in the activity, that is, do the activity over and over even if he or she does not want to, and finds it difficult to stop.
4. On cessation of the activity, the person often experiences withdrawal symptoms. These can include irritability, craving, restlessness, or depression.
5. The person does not appear to have control over when, how long, or how much he or she will continue the behavior (loss of control; e.g., he drinks six beers when he only wanted one, she buys eight pairs of shoes when she only needed a belt, he ate the whole box of cookies,: etc.);
6. The person often denies problems resulting from his or her engagement in the behavior, even though others can see the negative effects.
7. The person hides the behavior after family or close friends have mentioned their concern (e.g., hides food under the bed, hides alcohol bottles in the closet, does not show his or her spouse the credit card bill, etc.).
8. The person reports a blackout for the timé he or she was engaging in the behavior :(e.g., doesn't remember how much or what was bought, how much was lost gambling, how many miles were run on a sore foot, what was done at the party while drinking).
9. The person experiences depression. Because depression is common in individuals with addictive behaviors, it is important to make an appointment with a physician to find out what is going on.
10. The person has low self-esteem, feels anxious if he or she does not have control over the environment, and comes from a psychologically or physically abusive family.
This Webpage was created for a workshop held at Saint Andrew's Abbey, Valyermo, California in 2012