The American Psychiatric Association (2013), World Health Organization (2008), and American Society for Addiction Medicine (2010) have acknowledged
the existence of behavioral addictions to varying degrees and with
different, but similar, clinical criteria. Operationally, one of our authors,
Mark Griffiths (2005) builds on other researchers’ consensus to define a
behavioral addiction by six core components: salience, mood modification,
tolerance, withdrawal symptoms, conflict, and relapse. Salience means the
behavior becomes the most important activity in a person’s life and tends to
dominate his or her thinking, feelings, and behavior. Mood modification refers
to the emotional effect the behavior has on the individual which often
serves as a coping strategy and is reported as the arousing “rush” or the
numbing or the tranquilizing “escape” the behavior provides. Tolerance is the
process whereby increasing amounts of the behavior are required to achieve
the former mood-modifying effects, often meaning greater periods of time
are spent engaging in the behavior, and/or there is a desired escalation in
the intensity, recklessness, destructiveness, and ego-dystonic nature of the
behavior. Withdrawal symptoms are the unpleasant feeling states and/or physical
effects (e.g., the shakes, moodiness, irritability) that occur when the
person is unable to engage in the behavior. Conflict references discord
between the person and those around him or her (i.e., interpersonal conflict),
conflicts with other activities (i.e., social life, work, hobbies, and interests)
or from within the individual him- or herself (i.e., intrapsychic conflict
and/or subjective feelings of loss of control) that are concerned with spending
too much time engaging in the addictive behavior. Relapse addresses the
tendency for repeated reversions to earlier patterns of excessive behavior to
recur and for a common return to the most extreme patterns of excessive
behavior soon after periods of control.
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