Diagnostic Considerations
Disorders preceed diagnoses. This is true in any diagnosis. Therefore we need to acknowledge as mental health professionals that these disorders exist even if we currently do not have standardized diagnostic criteria or treatments for the disorders. To ignore our clients' distress and dysfunction would be potentially negligent.
The neurobiology underlying substance use disorders was not fully understood prior to including these in the DSM, so waiting for research that uses fMRIs to establish similar neurological pathways for behavioral addiitons is not consistent with previous practice.
The American Society of Addictive Medicine's (ASAM) definition of addiciton includes process addictions and can be found at http://www.asam.org/for-the-public/definition-of-addiction.
The neurobiology underlying substance use disorders was not fully understood prior to including these in the DSM, so waiting for research that uses fMRIs to establish similar neurological pathways for behavioral addiitons is not consistent with previous practice.
The American Society of Addictive Medicine's (ASAM) definition of addiciton includes process addictions and can be found at http://www.asam.org/for-the-public/definition-of-addiction.
Challenges to Diagnosing process Addictions
Many behavioral or process addicitons do not have standardized diagnostic criteria that may be used to diagnose.
Diagnoses for these disorders have been conceptualized as Impulse Control Disorders, Obsessive Compulsive Disorders, and Addictive Disorders.
Diagnoses for these disorders have been conceptualized as Impulse Control Disorders, Obsessive Compulsive Disorders, and Addictive Disorders.
DSM 5
The DSM 5 for the first time in history acknowedges the existence of behavioral or process disorders that have similarities with substance use disorders.
Gambling Use Disorder was added to the DSM 5 in the chapter on Substance-Related and Addictive Disorders, and Internet Gaming Use Disorder was added to Section III with specific criteria to encourage further study of this behavioral disorder.
In the chapter which includes Eating Disorders, the DSM 5 acknowledges similarities between eating disorders and substance use disorders which may implicate similar neurological processes. Additionally, Hoarding Disorder was added to the Obsessive-Compulsive Disorders chapter, and the disorder specifies that one subset of Hoarding Disorder involves compulsive spending.
Gambling Use Disorder was added to the DSM 5 in the chapter on Substance-Related and Addictive Disorders, and Internet Gaming Use Disorder was added to Section III with specific criteria to encourage further study of this behavioral disorder.
In the chapter which includes Eating Disorders, the DSM 5 acknowledges similarities between eating disorders and substance use disorders which may implicate similar neurological processes. Additionally, Hoarding Disorder was added to the Obsessive-Compulsive Disorders chapter, and the disorder specifies that one subset of Hoarding Disorder involves compulsive spending.
Disruptive, Impulse Control, and Conduct Disorders
Impulse Control Disorders include behaviors such as Kleptomania, Pyromania, and Intermittent Explosive Disorder, which hae been theorized to be forms of behavioral addicitons.
Obsessive Compulsive disorders
Obsessive-Compulsive Disorder involves obsessions (thoughts) and/or compulsions (behaviors), which take up more time than intended and are engaged in so that the individual may alleviate or avoid negative emotional states. These specific symptoms (obsessive thoughts or preoccupation with a behavior), compulsions (craving, tollerance, and withdrawal) to engage in the behavior, and use of the behavior to regulate anxiety or negative emotional states are consistent with all process or behavioral addictions.
Due to these similarities, within the diagnostic structure of DSM 5 we support using the Other Specified Obsessive-Compulsive Disorder, (write in the behavioral addiction) as the appropriate diagnostic classification. If there are existing diagnostic criteria used by treatment professionals who specialize in treating a disorder or within the research (i.e. Hypersexual Disorder diagnostic criteria or Internet Gaming Disorder criteria in section III of the DSM 5), then we encourage use of these criteria to make a determination regarding whether to give a diagnosis or not.
Due to these similarities, within the diagnostic structure of DSM 5 we support using the Other Specified Obsessive-Compulsive Disorder, (write in the behavioral addiction) as the appropriate diagnostic classification. If there are existing diagnostic criteria used by treatment professionals who specialize in treating a disorder or within the research (i.e. Hypersexual Disorder diagnostic criteria or Internet Gaming Disorder criteria in section III of the DSM 5), then we encourage use of these criteria to make a determination regarding whether to give a diagnosis or not.