Behavioral Addictions as Mental Disorders: To Be or Not To Be?

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Abstract

Should excessive and problematic engagement in nonsubstance use behaviors be mental disorders? The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) repositioned gambling disorder in the substance use disorders section and introduced Internet gaming disorder in the research appendix; the International Classification of Diseases (ICD-11) is also considering it. This article outlines pros and cons of considering behavioral addictions as mental disorders and also reviews the DSM-5 decision-making processes. It focuses on three conditions: gambling disorder, Internet gaming disorder (IGD), and Internet addiction (IA). We detail assessment methods and prevalence rates for these conditions and outline psychiatric comorbidities, demographic and biological risk factors, and promising treatment approaches. We also briefly discuss other putative behavioral addictions: eating/food, sex, exercise, shopping, and tanning "addictions." Overall, data are inconclusive, and consistent terminology and methodology are needed to define and evaluate these conditions more fully prior to considering them mental disorders.

Most cited references 105

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Development of a Facebook Addiction Scale.

Cecilie Andreassen, Torbjørn Torsheim, Geir Brunborg … (2012)

The Bergen Facebook Addiction Scale (BFAS), initially a pool of 18 items, three reflecting each of the six core elements of addiction (salience, mood modification, tolerance, withdrawal, conflict, and relapse), was constructed and administered to 423 students together with several other standardized self-report scales (Addictive Tendencies Scale, Online Sociability Scale, Facebook Attitude Scale, NEO-FFI, BIS/BAS scales, and Sleep questions). That item within each of the six addiction elements with the highest corrected item-total correlation was retained in the final scale. The factor structure of the scale was good (RMSEA = .046, CFI = .99) and coefficient alpha was .83. The 3-week test-retest reliability coefficient was .82. The scores converged with scores for other scales of Facebook activity. Also, they were positively related to Neuroticism and Extraversion, and negatively related to Conscientiousness. High scores on the new scale were associated with delayed bedtimes and rising times.

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Development and Validation of a Smartphone Addiction Scale (SAS)

Min-Sung Kwon, Joon-Yeop Lee, Wang-Youn Won … (2013)

Objective The aim of this study was to develop a self-diagnostic scale that could distinguish smartphone addicts based on the Korean self-diagnostic program for Internet addiction (K-scale) and the smartphone's own features. In addition, the reliability and validity of the smartphone addiction scale (SAS) was demonstrated. Methods A total of 197 participants were selected from Nov. 2011 to Jan. 2012 to accomplish a set of questionnaires, including SAS, K-scale, modified Kimberly Young Internet addiction test (Y-scale), visual analogue scale (VAS), and substance dependence and abuse diagnosis of DSM-IV. There were 64 males and 133 females, with ages ranging from 18 to 53 years (M = 26.06; SD = 5.96). Factor analysis, internal-consistency test, t-test, ANOVA, and correlation analysis were conducted to verify the reliability and validity of SAS. Results Based on the factor analysis results, the subscale “disturbance of reality testing” was removed, and six factors were left. The internal consistency and concurrent validity of SAS were verified (Cronbach's alpha = 0.967). SAS and its subscales were significantly correlated with K-scale and Y-scale. The VAS of each factor also showed a significant correlation with each subscale. In addition, differences were found in the job (p<0.05), education (p<0.05), and self-reported smartphone addiction scores (p<0.001) in SAS. Conclusions This study developed the first scale of the smartphone addiction aspect of the diagnostic manual. This scale was proven to be relatively reliable and valid.

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An international consensus for assessing internet gaming disorder using the new DSM-5 approach.

Nancy M Petry, Florian Rehbein, Douglas A. Gentile … (2014)

For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition. We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5. We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted. Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder. © 2014 Society for the Study of Addiction.

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Author and article information

Journal

Journal ID (iso-abbrev): Annu Rev Clin Psychol

Title: Annual review of clinical psychology

Publisher: Annual Reviews

ISSN (Electronic): 1548-5951

ISSN (Print): 1548-5943

Publication date (Electronic): May 07 2018

Volume: 14

Affiliations

[1 ] Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut 16032-3944, USA; email: npetry@uchc.edu , zajac@uchc.edu , mginley@uchc.edu.

Article

Mid ID: NIHMS971292

DOI: 10.1146/annurev-clinpsy-032816-045120

PMC ID: 5992581

PubMed ID: 29734827

SO-VID: f7a21e0c-7019-4ffa-8029-47999ba3d448

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Keywords: DSM-5,Internet addiction,gaming addiction,gambling disorder,Internet gaming disorder

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Keywords: DSM-5, Internet addiction, gaming addiction, gambling disorder, Internet gaming disorder

Behavioral Addictions as Mental Disorders: To Be or Not To Be?

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Most cited references 105

Development of a Facebook Addiction Scale.

Development and Validation of a Smartphone Addiction Scale (SAS)

An international consensus for assessing internet gaming disorder using the new DSM-5 approach.

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