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INTRODUCTION

The term "addiction" is derived from the Latin word addicere, meaning "bound to" or "enslaved by" (Potenza, 2006). In its original formulation, addiction was not linked exclusively to substance use behaviors. Several behaviors, besides psychoactive substance ingestion, may produce short-term reward that may engender persistent behavior despite knowledge of adverse consequences and may result in diminished control over the behaviors. Potential endophenotypes or underlying constructs such as aspects of motivation, reward processing, and decision making (Chambers et al, 2007; Redish et al, 2008; Goldstein et al, 2007) may be shared across a spectrum of substance- and non–substance-related addictive disorders. Aided by data from neurobiological studies, addiction professionals and the public are recognizing that certain nondrug behaviors warrant consideration as non substance or "behavioral" addiction (Frascella et al, 2010; Karim & Chaudhri, 2012). Behaviors such as gambling, Internet use, video-game play, sex, shopping, and eating may be addictive in nature (Holden, 2010), with a minority of individuals thought to display habitual or compulsive engagement in these behaviors (Chambers et al, 2007; Karim & Chaudhri, 2012).

Some of these potentially addictive behaviors were considered as "Impulse Control Disorders Not Elsewhere Classified" in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR), and this category was distinct from that containing substance-use disorders (SUDs). Although the conceptualization of impulse-control disorders (ICDs) as addictions or obsessive–compulsive spectrum disorders are not mutually exclusive and data exist to support both conceptualizations, these frameworks have important clinical implications with respect to prevention and treatment strategies. An important departure from past diagnostic manuals is the renaming of the "Substance-Related Disorders" diagnostic category to "Substance-Related and Addictive Disorders" in the recently published DSM-5. Pathological gambling (PG) (now termed gambling disorder) has been included in this category by the American Psychiatric Association in the DSM-5. This change reflects the increasing evidence that certain disorders resemble SUDs both behaviorally (e.g., involving diminished control, salience of behaviorally related cues) and neurobiologically (e.g., involving alterations in brain function, structure, and neurochemistry). Several other behavioral addictions were considered for inclusion; however, it was concluded that there is presently insufficient research to warrant their inclusion in the main section, although criteria for several behaviors (e.g., Internet gaming disorder) were included in Section III. This section, unlike the appendix of DSM-IV, contains diagnostic categories that require further research and ultimately aims to enhance our capacity to recognize and define the presence of these maladaptive behaviors as well as to promote further research.

PG represents the most thoroughly investigated behavioral addiction; consequently, this chapter largely focuses on PG, the relationships of PG and SUDs, and the current treatment and prevention strategies for PG. We also review and discuss other behavioral addictions including "Internet addiction," problematic video-game playing, hypersexual disorder, compulsive shopping behavior, and food addiction that, despite having been less well studied, have been receiving attention from clinicians and researchers.

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American Psychiatric Association. Diagnostic and Statistical ...

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