Emerging Conceptual Models of Excessive Behaviors

University of Hawaii-Manoa Department of Psychiatry, John Burns School of Medicine Honolulu USA
International Journal of Mental Health and Addiction (Impact Factor: 0.99). 05/2007; 5(2):107-116. DOI: 10.1007/s11469-007-9060-1


The clinical assessment of a common behavior that disrupts a person’s life only when it becomes excessive is controversial.
The inclusion of pathological gambling in the Diagnostic and Statistical Manual, Third Edition (DSM-III) in 1980 was one of
the initial formal attempts to develop diagnostic criteria for this type of behavior. The diagnostic criteria for pathological
gambling were based on substance dependency, but the disorder was classified as an impulse control disorder. One attempt to
resolve the controversy has been the development of a general psychological model of addiction that includes both substance
related behaviors and excessive behaviors. An example is the Griffiths component model that describes salience, mood modification,
tolerance, withdrawal, conflict and relapse as the central features of addiction. An addictive disorders section including
excessive behaviors and substance use disorders is one of the proposals for the DSM-V, scheduled to be published in 2012.

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    ABSTRACT: Behavior-based addictions are widely researched phenomena, though they are not included in the DSM-IV-TR (2000) with their substance-based counterparts. Exercise dependence is one such behavioral addiction that has garnered a lot of interest, yet is still poorly understood. The goal of the current study was to contribute to the understanding of exercise dependence by examining its latent structure. A community sample of 577 exercisers completed the Exercise Dependence Scale, Revised (EDS-R; Hausenblas and Downs, 2002b). The seven subscales of the EDS-R were used as indicators of exercise dependence in two taxometric analyses, MAMBAC and MAXEIG. Results of these analyses consistently indicated that the latent structure of exercise dependence is dimensional in nature, suggesting that exercise dependence represents an extreme on the full spectrum of all exercise behavior.
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    ABSTRACT: Background and Objectives: With the Cyberspace´s exponential growth of influence questions arise about its mental impacts. The presented study examines the question whether the dependent use of the Internet can be understood as an impulse control disorder, an addiction or as a symptom of other psychiatric conditions. Methods: Internet dependent patients seeking for psychiatric assistance and fulfilling the criteria for pathological Internet use (PIU) were examined with the Structured Clinical Interview according to DSM-IV (SCID), and a variety of questionnaires including the Barratt Impulsiveness Scale (BIS), the Beck Depression Inventory (BDI) and the Dissociative Experience Scale (DES). The patient group was compared to a matched group of healthy controls. Results: The adult patient-group consisted of 25 subjects, 76% male, with a mean age of 29.36 years. Average time spent in Cyberspace was 6.47 h/d, mostly in online-role-playing games. According to SCID I and BDI, 19 patients (76%) suffered from a depressive syndrome, with 10 cases of major depressive disorder (40%) and 8 cases of adjustment disorder with depression (32%). Six patients (24%) suffered from a comorbid anxiety disorder. Compared to controls, the patient group presented significantly higher levels of depression (BDI), impulsivity (BIS) and dissociation (DES). Conclusions: PIU shares common psychopathological features and comorbidities with substance related disorders. Therefore, it might be seen as a diagnostic entity in itself in a spectrum of behavioural and substance dependencies. Especially Internet role play may contain an addictive potential for adolescents and adults with subclinical psychopathology.
    European Journal of Psychiatry 03/2010; 24(3):136-145. DOI:10.4321/S0213-61632010000300002 · 0.46 Impact Factor