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Model of the addiction syndrome.
Contexts in source publication
Context 1
... extant evidence suggests that (1) many commonali- ties occur across different expressions of addiction and (2) these commonalities reflect shared etiology: a syndrome. Figure 1 illustrates a hypothetical chain of events lead- ing to the development of an addiction syndrome and its consequences. ...
Context 2
... Figure 1 shows, antecedents of the addiction syndrome include individual vulnerability levels, object exposure, and object interaction. More specifically, throughout the course of development, people encounter and accumulate specific combinations of neurobiological and psychosocial elements that can influence their behavior. ...
Context 3
... this stage of the syndrome, people teeter on a delicate balance that can shift them toward either more or less healthy behavior. Although distal antecedents of ad- diction (see Figure 1) are well documented, the proximal antecedents that influence further development of the syn- drome remain poorly identified-though these are likely to be biopsychosocial factors similar to those associated with distal influences. ...
Context 4
... addition, assorted expressions of the addiction syndrome (e.g., substance use disorders and pathological gambling) will share common manifestations and sequelae (e.g., depression, neuroadaptation, and decep- tion). Researchers and clinicians can identify the presence of the addiction syndrome when at least one of the shared man- ifestations and sequelae accompany the premorbid charac- teristics (see Figure 1). Unless this requirement is satisfied, researchers and clinicians should not make a diagnosis of ad- diction syndrome, because the presence of these central char- acteristics act as a diagnostic "gate" to identify the presence of a disorder. ...
Citations
... While the traditional approach to this assessment has been target-addiction-specific, we argue that the rapidly changing landscape of addictions warrants a more generalist, economic approach to the assessment of addictions, which assesses propensities towards substance and behavioural addiction broadly, as opposed to in relation to specific substances and behaviours. This generalist approach both mitigates practical challenges of the traditional target-addiction-specific measurement approach, while also coheres with a theoretical understanding of a shared aetiology and transdiagnostic conceptualization of addictions (Griffiths, 2005;Potenza, 2006;M.N. 2017;Shaffer et al., 2004;Shaffer and Shaffer, 2018) as well as their treatment Kim and Hodgins, 2018;Nunes, 2017;Sancho et al., 2018). A specific clinical concern where this more generalist approach could be especially helpful is the monitoring of addiction substitution (Kim et al., 2021), where reliably covering the full spectrum of addictive behaviours is a necessity 'per definition'. ...
Assessing addictive behaviours comprehensively and efficiently is a challenge in both research and clinical practice. Consequently, we tested the psychometric properties of the Generalized Screener for Substance and Behavioural Addictions (SSBA-G), a novel, brief screening tool measuring functional impairment resulting from both substance and behavioural addictions. The SSBA-G was developed from the Screener for Substance and Behavioural Addictions (Schluter et al., 2018) and tested in four samples including university students in Canada (n = 481) and the US (n = 164) as well as community adults in Canada (n = 301), and Hungary (n = 79). Confirmatory factor analysis supported the hypothesized bifactor model of the SSBA-G. Receiver-operation characteristic analyses revealed high differentiation accuracy (AUC=0.86-.95), as well as identical ideal cut points across the Substance Addiction (SSBA-G-S) and Behavioural Addiction (SSBA-G-B) Subscales. Results indicated good-to-excellent sensitivity and moderate-to-good specificity. The SSBA-G demonstrated excellent internal consistency and test-retest reliability as well as promising concurrent validity in relation to the original SSBA and additional questions regarding addiction-related impairment. The SSBA-G also showed good conver-gent and divergent validity with indicators of general mental health. These results indicate that the SSBA-G is a psychometrically sound and efficient measure of addiction-related impairment across substances and excessive behaviours.
... Yet, comorbid psychological conditions, especially SUDs, are common among individuals with gambling disorder (Dowling et al., 2015;Lorains, Cowlishaw, & Thomas, 2011). Given the considerable overlap in risk and maintenance factors between gambling disorder and SUDs, transdiagnostic theories of addictions propose addictive behaviors as representing the same underlying syndrome with different manifestations (Shaffer et al., 2004). More recently, Kim and Hodgins (2018) proposed a transdiagnostic treatment model for addiction that targets the overlapping maintaining mechanisms of both substance and behavioral addictions (e.g., emotion dysregulation, impulsivity). ...
... Participants also emphasized the disease model and used it as the basis for belief in different manifestations of the disease and as a motive for accessing recovery support. However, this perspective aligns more closely with The Syndrome Model of Addiction [44], which asserts that those with the syndrome are susceptible to substance-or behaviorbased addictive behaviors. Substitute behaviors have been discussed in terms of their instrumentality in fulfilling heterogeneous motives. ...
Background
Much remains unknown about the dynamics of substitute behaviors during addiction recovery among persons attending recovery support groups. Insight into the nature, motives for, and course of substitute behaviors could help to shape recovery support and harm reduction services.
Methods
Twenty-three semi-structured in-depth interviews (n = 14 males and n = 9 females) were conducted with a convenience sample of Narcotics Anonymous attendees from a number of groups in the Western Cape, South Africa. Participants ranged in age from 22—55 years (M = 39.3, SD = 9.35).
Results
Thematic analysis yielded four themes: (i) substance-to-substance substitution; (ii) substance-to-behavior substitution; (iii) substitute behaviors and harm (reduction) and (iv) support needs to manage and resolve substitute behaviors. According to the study, participants’ substitute behaviors developed across recovery stages; were temporary or long-term replacements for substance use disorders and were engaged for distraction, isolation from others, calming, assuaging boredom, keeping occupied, filling a perceived experiential void, modifying mood and to self-medicate. While substitutes were utilized for harm reduction or relapse prevention, the potential for ostensibly healthy behaviors to threaten recovery and lead to relapse was also recognized.
Conclusions
Self-monitoring, ongoing vigilance, and awareness of when substitutes become genuine addictions are critical for timely, suitable interventions.
... Therefore, some scholars have legitimately expressed concerns regarding overpathologizing common, everyday behaviours (Billieux, 2015;Kardefelt-Winther, 2017), while others argue the merits of addiction being viewed as a specific brain disease (Pickard et al., 2015;Valkow & Koob, 2015;West & Brown, 2013). Meanwhile, the syndrome model of addiction (Shaffer et al., 2004;Shaffer et al., 2018) suggests the specific object of desire (i. e. the internet in the online addictions) is merely a manifestation of an underlying addictive disease (Gomez et al., 2022). ...
... These results suggest that GD and SA are contingent upon symptomatic relationships unique to the behaviour of concern, rather than forming different behavioural manifestations of the same underlying construct (i. e. general addictive inclinations). These findings seem at odds with a syndromic model of addiction which hypothesises a singular addiction with various chemical and behavioural expressions (Grant et al., 2012;Shaffer et al., 2004;Shaffer et al., 2018;Gomez et al., 2022). Moreover, these findings reinforce the importance of properly understanding the symptomatic structure of distinct types of addiction(s), as well as legitimate inclusion criteria for the categorisation of 19 behavioural addiction, in order to avoid a false widening of the addictive spectrum (Billieux et al., 2015;Kardefelt-Winther et al., 2017;Zarate et al., 2022). ...
Contemporary literature and recent classification systems have expanded the field of addictions to include problematic behaviours such as gambling and sexual addiction. However, conceptualisation of behavioural addictions is poorly understood and gender-based differences have emerged in relation to how these behaviours are expressed. The current research conducted partial-correlation and Bayesian network analyses to assess the symptomatic structure of gambling disorder and sexual addiction. Convenience community sampling recruited 937 adults aged 18 to 64 years (315 females, Mage = 30.02; 622 males, Mage = 29.46). Symptoms of problematic behaviours were measured using the Online Gambling Disorder Questionnaire (OGDQ) and the Bergen Yale Sex Addiction Scale (BYSAS). Results indicate distinct gender-based differences in the symptom networks of sexual addiction and gambling disorder, with a more complex network observed amongst men for both conditions. Addiction salience, withdrawal and dishonesty/deception were important components of the addictive network. Interpersonal conflict was more central for women while intrapsychic conflict a more prominent issue for men. Differences in the two symptom networks indicate separate disorders as opposed to a single underlying construct. Treating practitioners and community initiatives aimed at addressing sexual addiction and disordered gambling should consider gender, when designing educational or therapeutic interventions.
... Yet, comorbid psychological conditions, especially SUDs, are common among individuals with gambling disorder (Dowling et al., 2015;Lorains et al., 2011). Given the considerable overlap in risk and maintenance factors between problem gambling and SUDs, transdiagnostic theories of addictions propose addictive behaviors as representing the same underlying syndrome with different manifestations (Shaffer et al., 2004). More recently, Kim and Hodgins (2018) have proposed a transdiagnostic treatment model for addiction that targets the overlapping maintaining mechanisms of both substance and behavioral addictions (e.g., emotion dysregulation, impulsivity). ...
The aim of the current umbrella review and meta-analysis was to evaluate the methodological rigor of existing meta-analyses on cognitive-behavioral treatment (CBT) for gambling harm. The Cochrane Database of Systematic Reviews, PsycINFO, and PubMed were searched for meta-analyses of CBT for gambling harm among individuals aged 18 years and older. The search yielded five meta-analyses that met inclusion criteria, representing 56 unique studies and 5,389 participants. The methodological rigor for one meta-analyses was rated high, two were moderate, and two were critically low. Including only moderate- to high-quality meta-analyses, a robust variance estimation meta-analysis indicated that CBT significantly reduced gambling disorder severity (g = -0.91), gambling frequency (g = -0.52), and gambling intensity (g = -0.32) relative to minimal and no treatment control at posttreatment, suggesting 65%-82% of participants receiving CBT will show greater reductions in these outcomes than minimal or no treatment controls. Overall, there is strong evidence for CBT in reducing gambling harm and gambling behavior, and this evidence provides individuals, clinicians, managed care companies, and policymakers with clear recommendations about treatment selection.
... Currently, several theoretical models attempted to explain which are the mechanisms of the disordered gaming. Three of those models are the Cognitive-Behavioural Model of Pathological Internet Use (Davis, 2001), the Syndrome Model of Addiction (Shaffer et al., 2004), and the Interaction of Person-Affect-Cognition-Execution model (I-PACE) (Brand et al., 2016(Brand et al., , 2019. ...
... The syndrome model of addiction by Shafer et al. (2004) considers all addictions as a syndrome, that is, a cluster of symptoms and signs related to an abnormal underlying condition; not all symptoms or signs are present in every expression of the syndrome, and some manifestations of a syndrome have unique signs and symptoms. The engagement in repeated interactions with a specific object or object of addiction and the neurobiological or social consequences of these interactions produce a desirable subjective shift that is reliable and robust, and the premorbid stage of the addiction syndrome emerges (Shaffer et al., 2004). This is a requirement for developing an addiction syndrome, which has shown some evidence, such as shared neurobiological and psychological antecedents and shared experiences. ...
In recent decades, video games have become a popular form of entertainment; so much so, that elite video gamers can be paid in a professional capacity. As such, the scientific community has shown interest in studying the short- and long-term consequences of playing video games, finding both positive (e.g., increasing time reaction) and negative effects.
One of the most studied negative effects of video gaming is Gaming Disorder (GD) or disordered gaming. The American Psychiatric Association (APA) defined GD in the 5th version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), with the World Health Organization’s 11th revision of the International Classification of Disease (ICD-11;WHO, 2019) following soon after. Each official body classifies GD as “a persistent and current use of the internet to engage in games, often with other players, leading to clinically significant impairment or distress” (APA, 2013; WHO, 2019).
Within the mental health field it is necessary to have reliable and valid tools to detect the presence or absence of disordered behaviour and also to observe said behaviours progress. For this reason, the main objective of the present dissertation is to adapt and validate two globally used scales, in order to obtain information about the psychometric characteristics of each scale and increase the knowledge about these tools in different cultural contexts.
The tools under examination are the Internet Gaming Disorder Scale Short-Form (IGDS9-SF; Pontes & Griffiths, 2015) and the Gaming Disorder Test (GDT; Pontes et al., 2021). Each scale was originally created and validated in English, and also adapted in several other languages. However, to date there has been limited adaption and validation of the IGDS9-SF in the Spanish language, and no adaptation or validation of the GDT in the Spanish language. Thus, the main aim of the present thesis is to address this crucial gap in the field.
Four studies will be presented to achieve this objective. The first two studies will aim to adapt each of the scales into Spanish, and then evaluate the reliability and validity
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using Classical Test Theory (CTT) and Item Response Theory (IRT). In addition, the measurement invariance in terms of gender will also be explored.
The third study will analyse the properties of each scale using the Mokken scale Analysis (MSA) to observe which items are more difficult and which items more discriminative, taking into account the different diagnostic and evaluation processes. Finally, the fourth study will investigate the measurement invariance of both scales, in order to observe if there are any differences in terms of professional and non-professional gamers.
The results of the four studies suggests that both the IGDS9-SF and the GDT are valid and reliable measures when assessing GD in the European Spanish population. In addition, it is also possible to know which items are more informative, more difficult and more discriminative. There was also a result regarding the non-differences in the evaluation of the GD across professionals and non-professionals.
In conclusion, the present doctoral dissertation highlights the effectiveness of the IGDS9-SF and the GDT measures to assess GD in European Spanish population and provides guidelines to consider during the diagnostic and prognostic process.
... In this paper we focus upon situational and structural characteristics -also called 'object exposure' and 'object interaction', respectively, by other authors (Shaffer et al., 2004)because they are solely or partly attributable to the gambling industry, and by juxtaposition in the present paper, to fan token providers. Situational characteristics refer to factors present in the environment that facilitate gambling involvement (e.g., the legal framework for gambling in a given jurisdiction, how available the product is for consumers, and the advertising and marketing of the product). ...
... To systematically explore the gambling-like features in fan tokens, a list of situational and structural characteristics was compiled consulting several sources (i.e., Griffiths 1993;McCormack & Griffiths, 2013;Parke & Griffiths, 2007;Shaffer et al., 2004). The terminology in those lists is sometimes imprecise, and many characteristics overlap or partially overlap with other authors' classifications. ...
Fan tokens are a form of cryptocurrency that allow owners to participate in various fan-related experiences such as voting on the music to be played during half-time breaks in sporting events. Since 2020, many elite sport teams have issued fan tokens, allegedly as a way to engage with fans and hear their voice. However, fan tokens also raise some concerns. They are largely gamified digital items that intend to keep fans within the providers' app. Also, they can be traded in exchange platforms, which arguably transform them into collectibles, whose value can vary over time. Here, we explore fan tokens through a case study from a football (soccer) club (i.e., an F.C. Barcelona fan token). Drawing on literature from situational and structural characteristics of gambling, we analyse the gambling-like features that fan tokens include in their product design. Such features are discussed from a public health perspective, comparing what they mean in gambling contexts and how potentially harmful they could be for fan token holders.
... Consequences of repeatedly engages in alcohol use will be high blood pressure, liver cirrhosis, and pancreatitis, while repeatedly interacts with a slot machine will be chasing losses and financial debt. But the common consequents are psychological distress, the use of addictive behavior to cope with negative affect and impairments in family life, and work life [46]. ...
Frontiers in Clinical Drug Research - CNS and Neurological Disorders is a book series that brings updated reviews to readers interested in advances in the development of pharmaceutical agents for the treatment of central nervous system (CNS) and other nerve disorders. The scope of the book series covers a range of topics including the medicinal chemistry, pharmacology, molecular biology and biochemistry of contemporary molecular targets involved in neurological and CNS disorders. Reviews presented in the series are mainly focused on clinical and therapeutic aspects of novel drugs intended for these targets. Frontiers in Clinical Drug Research - CNS and Neurological Disorders is a valuable resource for pharmaceutical scientists and postgraduate students seeking updated and critical information for developing clinical trials and devising research plans in the field of neurology.
The eleventh volume of this series features reviews that cover the following topics related to the treatment of a variety of CNS disorders, related diseases, and basic research:
The Multi-target Directed Ligands candidate (MTDLs) prototypes for neurodegenerative diseases
Drugs for relapse prevention in addiction
Neuroprotective activities of cinnamic acids and their derivatives in neurodegenerative disorders
Phytosome for targeted delivery of natural compounds in treating alzheimer's disease
Physical activity as a non-pharmacologic method for treatment of alzheimer's disease
... As a result, there has been a tendency to define this phenomenon as a set of elements when in fact each of those elements might represent different phenomena that do not usually occur together [12]. Some authors, such as Shaffer et al., have proposed alternative ways of thinking about this phenomenon, and suggested that addiction (which by definition could include EA) should be thought of as a syndrome that can have different forms of expression [97]. In this sense, a syndrome would allow EA to be thought of as a cluster of symptoms reflecting an abnormal underlying condition. ...
In a society that strives for appearance, fitness is increasingly viewed as a means to reach a certain aesthetic ideal, rather than a way to improve health and physical performance. Every day millions of posts appear on social media promoting a visual representation of apparently fit, healthy and 'perfect' bodies. Combining personal accounts, clinical cases, and scientific research, this book explores how such new trends in society can lead to the development of exercise addiction and body image disorders. It explains how such a concern with physical appearance can act as a precursor or be symptomatic of other conditions, such as eating disorders, mood disorders, and the use of performance and image enhancing drugs. It highlights throughout the importance of raising awareness amongst health professionals, including psychiatrists, psychologists, mental health nurses, social workers and primary care physicians, of this growing challenge to prevent harm and improve treatment.
... Other researchers have raised concerns about PG diagnoses because they lack a discrete addictive object (Quandt, 2017). All chemical addictions have a clear object: a specific drug (Shaffer et al., 2004). And even gambling disorder has an object: money. ...
Gaming Disorder was recently included in the 11th Edition of the International Classification of Diseases and Internet Gaming Disorder may be introduced in the sixth edition of The Diagnostic and Statistical Manual. Much is not understood about how problems with video games develop. This qualitative study aimed to better understand the development of problematic gaming through focus groups. Eleven young adult “frequent gamers,” twelve young adult “non-frequent or non-gamers,” and five older adult “non-gamers” discussed vulnerabilities and risk factors of problematic gaming. Participants across all groups believed that problematic gaming developed when people used video games as a primary means of meeting basic psychological needs that were unsatisfied, thwarted, or blocked outside of video games. Frequent and non-frequent gamers, compared to older adult non-gamers, were more likely to view video games as a healthy way to meet basic psychological needs and less likely to stereotype gamers. Video games are equipped to meet basic psychological needs for autonomy, competence, and relatedness. That is, gamers often experience a sense of agency, skill, and connection to others when playing video games. However, problematic gaming may develop when people with unmet psychological needs rely exclusively on video games to meet them. Treatment and prevention approaches to problematic gaming can benefit from greater attention to helping at risk individuals meet needs for autonomy, competence, and relatedness outside of video games.
