Are Behavioral Addictions “Real” Addictions?

When the DSM-5 debuted in 2013, a new category of addictions was officially introduced. While the concept of addiction has previously been based on drugs and alcohol, this new group pertains to something else entirely: behaviors.

Though for now, gambling disorder is the sole diagnosis in the category of behavioral addictions1 (also often called “process addictions”), internet gaming disorder is included in a special section of the manual indicating that further research should be conducted into its addictive nature. Some of the other behaviors that are believed to be potentially addictive include exercising, eating, working, sexual activity, shopping and various forms of excessive use related to the internet and video games.

While many mental health clinicians recognize these as legitimate addictions, there is still some debate around the topic. “The field has traditionally thought of addictions as involving ingested substances, and I think that this is still what addiction looks like in the minds of most laypersons as well as many professionals,” Julia M. Hormes, PhD, a psychology professor and researcher at the University of Albany at the State University of New York, told Psychiatry Advisor.

A recent study2 she co-authored, which appeared in the December 2014 issue of Addiction, used modified assessments for alcohol abuse and dependence, including DSM-IV-TR diagnostic criteria and the Alcohol Use Disorders Identification Test (AUDIT), to investigate disordered online social networking use among 253 college students.

Results showed that nearly 10% of participants met criteria for disordered use of social networking, meaning they had symptoms “commonly thought of as being characteristic of addiction, including tolerance (spending more and more time on Facebook), withdrawal (anger or irritability when unable to access the site), and cravings or strong urges to access Facebook,” said Hormes.