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      The Contribution of Sex, Personality Traits, Age of Onset and Disorder Duration to Behavioral Addictions

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          Abstract

          Background and aims: Increases in the prevalence of behavioral addictions worldwide have led to a growth in the etiological research of the specific contribution of risk/protective factors to these disorders. The objective of this study was to assess the relative role of patients' sex, age of disorder onset and disorder duration on the clinical profile of behavioral addictions.

          Methods: Our sample included treatment-seeking patients diagnosed with gambling disorder (GD, n = 3,174), internet gambling disorder (IGD, n = 45), compulsive buying (CB, n = 113), and sex addiction (SA, n = 34).

          Results: The pattern of associations between the independent variables and the outcomes were strongly related to the behavioral addiction subtype: (a) for GD-men early onset of the disorder was related to GD severity, while for GD-women early onset was linked to novelty seeking; (b) for IGD-men, late onset correlated with addiction severity, worse psychopathological state, and high harm avoidance and self-transcendence levels; (c) for CB-women, early onset was related to higher reward-dependence scores and lower self-transcendence levels, and longer duration predicted higher cumulate debts; for CB-men, early onset and long duration correlated with high scores in harm-avoidance, self-directedness, self-transcendence, and cooperativeness; and (d) for SA-men, late onset and longer duration correlated with high disorder severity.

          Discussion and Conclusions: These findings are relevant for developing prevention and treatment programs specific to different behavioral addictions.

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          Most cited references43

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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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            Prevalence of the addictions: a problem of the majority or the minority?

            An increasing number of research studies over the last three decades suggest that a wide range of substance and process addictions may serve similar functions. The current article considers 11 such potential addictions (tobacco, alcohol, illicit drugs, eating, gambling, Internet, love, sex, exercise, work, and shopping), their prevalence, and co-occurrence, based on a systematic review of the literature. Data from 83 studies (each study n = at least 500 subjects) were presented and supplemented with small-scale data. Depending on which assumptions are made, overall 12-month prevalence of an addiction among U.S. adults varies from 15% to 61%. The authors assert that it is most plausible that 47% of the U.S. adult population suffers from maladaptive signs of an addictive disorder over a 12-month period and that it may be useful to think of addictions as due to problems of lifestyle as well as to person-level factors.
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              Should compulsive sexual behavior be considered an addiction?

              To review the evidence base for classifying compulsive sexual behavior (CSB) as a non-substance or 'behavioral' addiction.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                16 October 2018
                2018
                : 9
                : 497
                Affiliations
                [1] 1Departament de Psicologia Clínica i de la Salut, Autonomous University of Barcelona , Barcelona, Spain
                [2] 2Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III , Madrid, Spain
                [3] 3Departament de Psicobiologia i Metodologia, Autonomous University of Barcelona , Barcelona, Spain
                [4] 4Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain
                [5] 5Department of Clinical Sciences, Faculty of Medicine, University of Barcelona , Barcelona, Spain
                [6] 6Departamento de Educación y Psicología, Centro Universitario Cardenal Cisneros, Universidad de Alcalá , Madrid, Spain
                [7] 7Nursing Department of Public Health, Maternal and Child Health, University of Barcelona , Barcelona, Spain
                [8] 8CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III , Madrid, Spain
                Author notes

                Edited by: Roumen Kirov, Institute of Neurobiology (BAS), Bulgaria

                Reviewed by: Mauro Pettorruso, Catholic University of Rome, Italy; Drozdstoy Stoyanov Stoyanov, Plovdiv Medical University, Bulgaria; Cristina Segura-Garcia, Università degli Studi Magna Graecia di Catanzaro, Italy

                *Correspondence: Susana Jiménez-Murcia sjimenez@ 123456bellvitgehospital.cat

                This article was submitted to Psychopathology, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2018.00497
                6198171
                30386263
                944e5c2a-2179-47e7-ae11-3bac715d0111
                Copyright © 2018 Valero-Solís, Granero, Fernández-Aranda, Steward, Mestre-Bach, Mallorquí-Bagué, Martín-Romera, Aymamí, Gómez-Peña, del Pino-Gutiérrez, Baño, Moragas, Menchón and Jiménez-Murcia.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 June 2018
                : 21 September 2018
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 52, Pages: 9, Words: 6953
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                behavioral addictions,compulsive buying,internet gambling disorder,gambling disorder,sex addiction,age

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