When we think of an addiction, we usually think of an addiction to a substance, such as alcohol or certain psychoactive drugs. However, addictions can go beyond that, and the reality is that we can be addicted to practically anything.
Thus, addictions that do not involve a chemical are called behavioral addictions.
In this article we will talk about the most frequent behavioural addictions , such as addiction to gambling or new technologies. We will discuss their symptoms, their causes and their treatments (these last two aspects in a more generic way).
What is an addiction?
Before we learn about behavioral addictions, let’s explain what an addiction is. An addiction is a psychological disorder that implies, for the person, a great need to consume a certain substance or to perform certain actions .
When it is unable to do so, it manifests the so-called withdrawal syndrome, a syndrome normally characterized by symptoms opposite to those that the substance or object in question would produce. That is to say, if alcohol, for example, produces “depressive” symptoms in us (at a physiological level), the withdrawal syndrome will cause the opposite symptoms: over-excitement, nervousness… but at a level of intensity that is very disturbing for the individual.
So, broadly speaking, an addiction involves two basic symptoms: dependence on the substance or object in question (the person “needs” it) and excessive consumption of it . This consumption (or overconsumption) can be very harmful for the person, at a health level (especially if we are talking about addictions with substance).
In this way, and in a very generic way, we can differentiate two large groups of addictions:
- addictions with substance (usually a chemical such as alcohol, cocaine, or tobacco)
- Addictions without substance (i.e., behavioral addictions, such as shopping or sex addiction).
In fact, the DSM-5 itself (Diagnostic Manual of Mental Disorders) (APA, 2013), includes, to talk about addictions, the category of “Addictive and Substance-Related Disorders” , and within its chapter these two large groups mentioned (addictions with and without substance) are included.
Behavioral addictions: what they are, and symptoms
Now that we have seen what an addiction involves, let’s talk in more detail about behavioral addictions. Their main characteristic, as we have seen, is that they are addictions without substance. That is, what creates addiction is not a substance, but an object, an action, a product , etc.
Let’s look at some of the most common behavioral addictions:
1. Internet game addiction
This first of the behavioral addictions is not yet considered an official diagnosis and has been included in Section III of DSM-5, in the section “Conditions for further studies in the future”, under the name “Internet gaming disorder”. However, many researchers consider it an existing disorder.
It consists of the addiction to those virtual games of the network (not including gambling games), which consume the user a time of between 8 and 10 hours a day . Its prevalence in children and adolescents is very high (8.4% in males and 4.5% in females), especially in China and South Korea.
2. Game addiction
Pathological gambling is another behavioral addiction, which is covered in the DSM-5 itself. This pathology, in the DSM-IV-TR, was included in the Impulse Control Disorders, but with the arrival of the new edition of the Manual, it is now considered an addictive disorder (without substance), since its great similarities with the addictions with substance are observed (dependence, tolerance and abstinence).
Thus, pathological gambling is characterized by the involvement of unadaptive and persistent gambling behavior, coupled with symptoms of deterioration and stress in the individual’s life.
In addition, other types of symptoms appear (lasting at least 1 year), such as: cheating one’s family to hide the degree of involvement with gambling, worry about gambling, attempts to recover lost money the next day, failure to control or stop gambling, restlessness or irritability when trying to stop gambling, etc.
This disorder appears in 0.2-0.3% of the general adult population , and its rates are higher in adolescents and university students.
3. Internet Addiction
Although Internet addiction (or addiction to new virtual technologies as a whole) is not included as a disorder in DSM-5, it is true that, given the empirical evidence, it could be considered another of the most prevalent behavioral addictions today.
It is a reality that more and more children and adolescents (and also adults) are addicted to the Internet, social networks, new technologies, etc. This addiction translates into a constant need to consult the Internet and/or social networks , to stay connected to mobile phones all day long, etc.
In other words, there is an excessive consumption of new technologies and an associated concern about not being able to use them.
The most serious problem of this type of alteration is that other problems associated with this addiction appear, such as family problems, conduct disorders, low self-esteem, eating disorders , etc.
Other behavioral addictions
We have seen some of the behavioral addictions (the most known), however there are many more, such as: sex addiction, shopping addiction…
Whether or not they are included in the DSM-5, it is an undeniable reality that these addictions appear in a large part of the population, or if not, addictive behaviors that could constitute a serious problem by interfering in the person’s daily life.
These addictions share common characteristics, such as excessive consumption, dependency, and associated discomfort with the inability to consume the object of desire / the addictive object.
Why do we become addicted to certain substances (in this case, objects or actions)? The causes will vary greatly from person to person, although it is true that we can talk about some causes more typically than others: family problems, couple problems, need to escape from reality, low self-esteem, poor impulse control , low tolerance to frustration, social isolation, harassment, bullying, illusion of control, etc.
In the case of behavioral addictions, logically, it is not the same to be addicted to sex as it is to shopping or the Internet, but many times the causes are similar.
In relation to the treatment of behavioral addictions, each treatment must be adapted to each specific case, because each person will manifest his or her own symptoms, added problems, concerns, etc.
However, we can speak, in general terms, of therapeutic options that are often used and have proven to be effective in the case of this type of addiction . Some of them are:
- Cognitive behavioural therapy: with techniques such as exposure with response prevention (widely used in pathological gambling).
- Cognitive therapy: with techniques such as cognitive restructuring, relaxation, etc.
- Pharmacological therapy: with the prescription of anxiolytics and antidepressants
What is clear is that, in addition to addressing the nuclear symptomatology of addiction, the root of the problem, i.e. its cause, must be addressed. Ideally, the problem should be approached from a multidisciplinary and systemic perspective, where the patient’s environment is also addressed.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th. Edition (DSM-5). Washington, DC: American Psychiatric Association; 2013.
- A. Company (2013). Non-substance related addictions (DSM-5, APA, 2013): a first step towards the inclusion of Behavioral Addictions in the current categorical classifications. Rev Neuropsychiatry, 76(4):210-217.
- Echeburúa E, Corral P. Addiction to new technologies and social networks. Addictions. 2010; 22, 91 – 96.
- Echeburua E, Corral P, Amor PJ. The challenge of the new addictions: therapeutic objectives and ways of intervention. Behavioral Psychology. 2005; 13: 511 – 525.
- Riva-Posse, A.E. (2016). Addictive Disorders, Immanence, 5(1): 51 – 57.