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      Attachment and emotion regulation in substance addictions and behavioral addictions

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          Risky behaviors have been related to emotional regulation and attachment, which may constitute risk factors for developing an addictive behavior. However, there may also be differences between substance and non-substance-related addictions.


          This study aimed to examine the relationship of emotional regulation and attachment, with substance (alcohol and drug abuse), and non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use) in adolescents and emerging adults. The study also aimed to examine gender differences for such predictors.


          The sample comprised 472 students aged 13–21 years recruited from high schools and vocational education centers.


          Findings demonstrated that emotion regulation was predictive of all addictive behaviors assessed in this study (alcohol and drug abuse, gambling disorder, video game addiction, and problematic Internet use), whereas attachment predicted non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use). In addition, gender differences were found, with females scoring significantly higher in maternal and peer attachment, whereas males scored significantly higher in gambling disorder and video game addiction.


          The findings may be useful for preventive and clinical interventions conducted with youth regarding addictive behaviors.

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          Most cited references 94

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          Introduction to behavioral addictions.

          Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior, despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or "behavioral" addictions. Inform the discussion on the relationship between psychoactive substance and behavioral addictions. We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions. Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
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            The CAGE questionnaire: validation of a new alcoholism screening instrument.

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              Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis.


                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                26 December 2017
                December 2017
                : 6
                : 4
                : 534-544
                [ 1 ]Department of Personality, Psychological Assessment and Psychological Treatment, University of Deusto , Bilbao, Spain
                [ 2 ]International Gaming Research Unit, Nottingham Trent University , Nottingham, UK
                Author notes
                [* ]Corresponding author: Ana Estévez; Psychology Department, University of Deusto, Apartado 1, 48080, Bilbao, Spain; Phone: +34 944 139 000 ext. 2878; Fax: +34 944 139 085; E-mail: aestevez@
                © 2017 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 98, Pages: 11
                Funding sources: None.
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