From: ALLENTOWN, PA
School: Thomas Jefferson University
Addiction- Gambling, Pornography, Smartphone
addiction and Disorders 1
Addiction: Gambling, Pornography, and Cellphones
The meaning of addiction is a topic that is discussed by many and has been studied for the last couple of decades. The use of subjective and objective information is used to outline the parameters of addiction and disorders and how they fit into the DSM V criteria handbook. This paper identifies the meaning of addiction through the use different model perspectives, symptoms, and etiology in order to connect gambling, pornography and cellphones use. Aspects of gambling addiction is explained through multiple studies and treatments. The same is done with the discussion of pornography addictions but it is reviewed through a moral model in order to explain its prevalence and how it affects the general population. The aspects of smartphone use disorder are also explained through the perspective of its effects on the abuser and how it is used as a coping-mechanism. Overall, evidence-based information is used to explain why these disorders are relevant and real to the general population, and how they are a result of unresolved trauma.
Addiction is a sum of choices and influences whether it be genetic or psychological factors that increases the need to “search for a sensation”. It starts as a choice; a need that builds up as a person’s ability to function normally in society decrease. The thing that’s was once a “escape” becomes a burden, a burden that plagues the mind and the physical body. In society drugs are seen as a plague that only afflict the weak, while others that use drugs or those who are struggling to remain clean see it as an out from the realities and hardships of life. A place where responsibilities aren’t given and where life is much simpler. Addiction is not something that you can “”shake off” or “pray away”, it is a chronic relapsing brain disease that is characterized by compulsive behaviors despite its harmful effects (Adès, 2020). Addiction comes in many forms like gambling, pornography, and cellphones all ending with the same result of change within the structure and function of the brain at different degrees.
The criteria for an addictive disorder all start with an addictive process, a process that
includes the subject being engaged in behaviors that results from the meeting between the addictiveness of a subject and the addictogenic potential of a product or behavior (Adès, 2020). This behavior is further strengthened by pleasure-seeking actions that release dopamine in the brain giving the subject a “high”. This process is then exaggerated through the repetitive actions of the addictive behavior resulting in a dependence. This dependence grips an individual causing them to lose some or all self-control due to the drug/behavior (Kuhar, 2015). Drugs/behaviors can therefore “push the brain around” and override its natural procedure by taking over the process of chemical transmission (Kuhar, 2015). This override of the brain is how an addictive disorder initiates.
Gambling is an activity characterized by the balance between winning and losing, which is governed by skill and the element of chance (Mayo Clinic, 2016). Gambling becomes a disorder when the uncontrollable urge to gamble overcomes one’s life despite the negative consequences. A gambling disorder can lead to the depletion of savings, the accumulation of debt and even resort in theft or fraud to support the addiction (Mayo Clinic, 2016). More than 2 percent of Americans are affected by this mental disorder (Mayo Clinic, 2016). Gambling is the only addiction that is purely behavioral dependent, it is currently acknowledged as addictive in the DSM 5 handbook (Ross, 2020). Gambling gives off the same response as any other addictive disorder, it stimulates the reward system of the brain like drugs and alcohol (Mayo Clinic, 2016). Through the behavioral study of animals, it has been discovered that the less frequent a reward is, the greater the want becomes; this pattern of events reinforces the addictive behavior prolonging its hold on an individual (Kuhar, 2015).
Symptoms of compulsive gambling include obsessing over any type of gambling activity, the inability to stop gambling or cut down, lying to family members or others about your gambling habit, and jeopardizing or losing important relationships, a job, or work opportunities as a result of gambling (Mayo Clinic, 2016). Having a gambling addiction is like having a substance use disorder, the higher the dose is, the greater the high feels. Bets gradually get larger and larger to achieve the same thrill once before, this is known as sensation chasing. Sensation chasing goes hand and hand with and individual chasing their losses while gambling. When a compulsive gambler gambles they start by chasing a sensation like there first big win, they later end up trying to chase their losses in order to get some money back. This cycle continues until treatment is implemented.
Studies on gambling disorders are currently in its infancy stage due it be being behavioral reliant, in saying this studies have found that gambling leads to changes in levels of subjective mood states (Ramoz, Derrington, & Dreher, 2020). More importantly, mood states influence an individuals’ risky behaviors in gambling and can act as predictors for a gambling disorder. These uncontrollable mood states are then regulated by the persistent behavior of gambling. A predominate factor that contributes to theses mood states are the ineffective regulation of the hormone’s testosterone and cortisol. Individuals with low cortisol levels are at high risk of developing gambling addictions, while high levels of testosterone elevate gambling behaviors. Causes of compulsive gambling are not fully understood, but like many other disorders compulsive gambling is a combination of biological, genetic and environmental factors (Mayo Clinic, 2016).
Treatment approaches include behavioral or cognitive therapy to unlearn these compulsive behaviors while identifying unhealthy and negative beliefs. This identification of unhealthy beliefs allows the patient to then replace them with healthy and positive beliefs that will benefit the patient’s life. On the other hand, affective states are known to be regulated by medications likes mood stabilizers and antidepressants (Mayo Clinic, 2016). The implementation of medication has shown to effectively reduce gambling behaviors. In addition to therapy and medication, self-help groups have proven to be a helpful part of treatment. These groups allow others that struggle with the same problem to talk about their issues in a safe and friendly environment. Treatments for compulsive gambling may be done in an outpatient program, inpatient program or a residential treatment program depending on the severity of the disorder, and availability of resources (Mayo Clinic, 2016).
Addiction is historically described in three models, it is seen through a psycological, medical and moral lens. A conflicting outlook on addiction mainly comes from the disscussion of the moral model, especially when it comes to any sexual behavioral disorder like pornography addiction. When the moral model was implemented addiction was surrouded by stigma, blame and embarrassement. Addiction was seen to be a personal choice and a failure of personal responsibility, with this being said pornography currently has the same stigma and outlook (Lewczuk et al., 2020). For a sexual behavior to be considered as a addiction it has to cross a certain threshold, a thin line between voluntary and involuntary. Sex is a fundamental element of life, it allows for the survival of a species, it is a instinctual drive. Sexual behaviors start to become perverted when this drive becomes intensified and leads to out-of-control behaviors (Lewczuk et al., 2020). The excessiveness of sexual behavior combined with risk and consequences is what leads to the impairment of life (an addiction).
Pornography addiction is not a disorder in itself, porn addiction still remains as a controversial topic hence why it has not been admitted in the DSM 5 handbook. Nonetheless, the prevalence of pornography addiction is about 3-6 percent of the general population, however the rates are difficult to identify due to the lack of a formal classication (Kor et al., 2013). Pornography addiction is placed under the umbrella term compulsive sexual behavior disorder, it is also refered to as hypersexual disorder. Compulsive sexual disorder is characterized by a lasting pattern of diminished self-control over behavioral engagement, repetitive sexual urges resulting in the enactment of sexual behavior over a period of time, and the impairment of personal, social, occupational or other important areas of functioning due to the sexual behavior (Kor et al., 2013). Symptoms also include an appetite or craving for behavioral engagement (Kor et al., 2014). The manifestation of this disorder is reinforced by the repetitive actions of the sexual behavior, later along the addiction process this action becomes the sole focus of a persons life even when faced with adverse consequences.
The appearance of hypersexual behavior/compulsive sexual behavioral disorder is often paired with other psycological diseases. Common co-occuring disorders of hypersexual behavior are internalizing conditions like OCD that affect a large percent of the population (Kor et al., 2013). In one study, 72% of patients with hypersexual behavior reported to have mood disorders, the other 38% reported to have an anxiety disorder, and 40% of patients also reported to have a substance use disorder (Kor et al., 2013). Emotional triggers inducing sexual urges may include sadness and depression, happiness, loneliness, and shame (Kor et al.2013). Overall, identifying and treating hypersexual behavior will help in relieving its symptoms and the co-occurring disorder. An example of a co-occurring disorder with hypersexual behavior is substance use disorder. Studies in which men take methamphetamine have reportedly found an increase in sexual desire and sensation while decreasing sexual restraint (Kor et al., 2013). In summary, drugs and sex both act through shared mechanisms of the brain, hence why treating one disorder helps lessen the symptoms of the other co-occurring disorder. Underlying mental health conditions can increase the chances that an individual may develop a compulsive sexual behavior disorder, the use of pornography may be used as a release of psychological distress which progresses the addiction (Kor et al., 2013). Relationship problems can cause an individual to use pornography as a crutch to satisfy their sexual need rather than communicating their sexual dissatisfaction with their partner (Kor et al., 2013). Societal rules and biological factors play a part in developing this disorder. Unhealthy cultural norms may draw people to pornography through the need of emulation of certain sexual behaviors to be “normal” (Kor et al., 2013). The most influential component that causes the development of hypersexual behavior is biological factors. Changes in brain chemistry alter the perception of reality, this causes people to be more susceptible to having a disorder based on the response that pornography ignites in a person.
An addiction to pornography is not something you can cure by simply going “cold turkey”. A problem that can arise from this approach is that the individual gains no coping skills on how to use the internet in a beneficial way. Instead the individual needs to learn how to utilize the internet in a way that does not result in relapse. The implementation of psychotherapy, relationship counselling, medication, and they act of continuously going to self-help groups can contribute to and individual gaining control of their behavior, as well as live on to lead a healthy life. Psychotherapy can be used to understand the underlying nature of the patient’s motives that drive their sexual behavior. This allows the patient to focus on the internal aspects of their thoughts and feelings associated with sexuality to identify their problems, while obtaining insight that can lead to creating healthy behaviors (Young, 2008). Psychotherapy includes the use of the approach of Acceptance and Commitment Therapy (ACT) where a patient accepts their disorder so they can change their behavioral outcome (McBride, 2019). Relationship counseling comes into play when the disorder originates within a relationship. Counselling can help partners work on values and issues within the relationship in a safe environment. It allows both partners to speak up about any sexual dissatisfaction that caused the disorder to arise. To treat addiction, you must first normalized dopamine intake. Dopamine is a type of neurotransmitter that is released in response to a pleasurable stimulus, this neurotransmitter is then taken up by dopamine receptors which give off action potentials to certain areas of the brain (Bostwick, & Bucci, 2008). If the number of available dopamine receptors where to be unavailable for “docking”, then the pleasurable sensation will not be as strong. Medications like Naltrexone can be used in this same way to aid in the treatment of compulsive sexual behavioral disorder (Bostwick, & Bucci, 2008). Another result of being treated with medication is that it can be used to treat or lessen the symptoms of other co-occurring conditions (Kor et al., 2013).
Treatment allows individuals to self-reflect and raise awareness of their own underlying issues driving their online sex addiction. The reevaluation of life choices allows the patient to observe the harm that has come from Internet sex in their lives. Introspection allows the patient to emotionally begin to develop/rebuild positive relationships again and promote a healthier sexuality (Young, 2008). The recovery process is an ongoing journey that relieves shame, corrects negative behaviors, and promote learning opportunities through mistakes.
All advancements in technology are good, right? They give us the advantage of understanding our environment, and the human body and mind, but is too much information a burden or a gift? As technology advancements carry on and revolutionize our world, distractions like social media platforms, gaming apps/systems, and dating applications are invented. The advancement of technology through cellphones draw us farther and farther away from actual human interaction rather than globally connecting people. I agree that technology is a revolutionizing resource, but it has also isolated many, and consumed others in unrealistic an unattainable expectations of the world and people. Cellphones have regressed people socially as much as it has helped people access resources an information. Ever since the invention of the World Wide Web in 1989, the Internet has dramatically reshaped all walks of life. With resources available at a click of a button, it has expanded the spectrum of Internet-related disorders.
Smartphone use disorder is a relatively new and debated concept due to it having many components that include social media, gaming platforms, and the internet. The prevalence of this disorder is not clearly identified within the general population, its only acknowledgment that this 91% of Americans think that this addiction is real (Lee et al., 2018). Smartphone use disorder (SmUD) is perceived to be the mobile form of internet use disorder (IUD), because smartphones are merely a medium to access different kinds of online content ( Montag, & Becker, 2020). Studies on cellphone addiction are currently very limited and debated if it is a real disorder, this debate has led to the creation of the term nomophobia. Nomophobia is the fear of being without access to a working cellphone (Lee et al., 2018). Nomophobia is considered as a modern phobia that is characterized by the feeling of discomfort when an individual is unable to use/utilize their mobile phone (Montag, & Becker, 2020). Individuals experience the same symptoms of addiction, like the need to fulfill appetitive urges, a state of being immersed in uncontrollable usage, and the inability to regulate usage to the point of experiencing consequences in one’s daily life (Yu & Sussman, 2020).
Smartphone use disorders utilize 3 factors of a person in order to develop into an addiction, it uses psychological characteristics, emotional characteristics, and social-environmental characteristics to thrive (Kim, 2013). The excessive use of cellphones is employed as a distraction-based coping mechanism to deal with unpleasant feelings from past traumas. This coping method plays along with characteristics of depression, loneliness, social anxiety, and impulsivity (Yu & Sussman, 2020). Those with severe behavioral and emotional problems are at a higher risk of developing a smartphone addiction, this also pertains to those (especially the youth) that have a low self-esteem, obsessive personalities/traits and poor quality of communication with their parents (Yu & Sussman, 2020). Extroverted personality traits are more inclined to use their mobile devices to maintain their social presence and gain social relationships, making this population more susceptible to developing a smartphone addiction.
Programs that treat smartphone addictions are primarily done through the application of therapy. A cognitive behavioral approach of therapy can be implemented to help in the individual recognized their thoughts and feelings that motivate their excessive use of cellphones (Kim, 2013). Contemporary approaches are also used to treat this addiction, the practice of therapeutic recreation, mindfulness behavioral cognitive treatment, and exercise therapy can be used to focus on environmental factors while using different activities to help treat smartphone addiction (Kim, 2013). These tactics of treatment can help in preventing relapses an allow the patient to be aware of cues that trigger the misuse of cellphones. These therapy has proven to be important in factor in tackling smartphone addiction in the younger generations (Kim, 2013).
Conclusion Do you believe these are “real” disorders? Why or why not?
Addiction is the malfunctioning of the brain’s reward center; this malfunction is a common factor in all addictive behaviors including behavioral addictions. The reward center governs all behavior through a pleasurable sensation that includes eating food, having sex, and all basic survival instincts. If a pleasurable feeling is what governs the brain, then anything that replicates this sensation can control the brain as well. I believe that anything done excessively can become a disorder/addiction, as long as it alters the regular “programing” of the mesolimbic system. Any individual can develop and gambling addiction, a pornography addiction and/or smartphone use disorder. All of these mental disorders are real, they all shared common symptoms like the inability to control behavior and usage, an appetitive craving for the behavior, the inability to stop behavior even when faced with adverse consequences, and the interference of life/daily activities done by the addiction. All of these factors are biological, psychological, and genetic based, this means that they can develop within anybody. A person can be addicted to pornography because they are addicted to the sensation that it gives them; this also applies to gambling and can even be used to explain how a person can be addicted to their smartphone. Being addicted to your smartphone does not mean that you are conceited, it means that you are using your smartphone as a shield against the outside environment and the trauma that it holds. Trauma is universal and it comes in different forms, this trauma is handled in different ways whether it be negatively or positively. If these coping skills are ineffective the unsettled trauma can manifest itself into a disorder, hence why there are so many mental disorders.
Adès, J. (2020). Addictions. definitions and limits of the concept. [Les addictions. Définitions et limites du concept] Neuropsychiatrie De l’Enfance Et De l’Adolescence, doi:10.1016/j.neurenf.2020.02.001
Ross, D. (2020). Addiction is socially engineered exploitation of natural biological vulnerability. Behavioral Brain Research, 386 doi:10.1016/j.bbr.2020.112598