
Process Addiction Assessments - A Guide to Behavioral Addiction
Introduction
Table of Contents
Addiction has two main categories: substance addiction and process addiction. Substance addiction includes abuse and dependence to alcohol or drugs. Process addiction includes compulsive behaviors such as gambling, excessive shopping, eating disorders, exercising too much, sex addictions, and various addictions involving computer devices. These are serious mental health issues that usually require treatment.
It’s important to understand that process addictions can be just as serious as drug addiction problems in how they impact life. In both cases, addictive behavior develops because of one or more underlying issues that need diagnosing and behavioral addiction treatment.
What is Process Addiction?
Process addictions are defined by behavioral issues that don’t involve substances. Also known as behavioral addictions, process addictions are typically impulse control disorders. Let’s start by taking a closer look at the definitions of addiction, behavior, and compulsiveness as they relate to psychiatric disorders.
Addiction
Behavior
Compulsive
- Substance use disorders
- Behavioral disorders
- Obsessive-compulsive disorders
Common Features of Substance Use Disorders and Process Addictions
- The activity dominates the person's life
- The person experiences euphoria (a high or a buzz) from doing the activity
- Tolerance develops so the activity must be performed to a greater extent to obtain the same euphoria
- Stopping or cutting down on the activity leads to distressing emotions or adverse physical effects
- The activity causes conflicts with others or self-conflict
- Resuming the activity happens at previous or worsening levels after the person tries to stop due to negative consequences that damages their job, school, or family obligations
Why a Process Addiction Assessment is Important to Comprehensive Diagnostic Testing
Because behavioral addictions look like substance use disorders, a process addiction assessment must be done as part of comprehensive diagnostic testing. While drug and alcohol abuse may be easier to spot, it’s still vital to uncover process addictions before establishing a treatment plan.
Sex Addiction vs. Pornography Addiction
Sex Addiction
Sex addiction is also known as compulsive sexual behavior. Sexual addiction is characterized by people frequently engaging in sexual activities even though they cause negative consequences.
Engaging in sexual behaviors are ways of dealing with stress or physical or emotional pain. Sexual behavior becomes the major way of dealing with problems, but unfortunately, it leads to more problems and feelings of shame and desperation.4
Pornography Addiction
Pornography addiction has been a growing problem because of how easily pornography can be reached on the internet. Some terms that are related to pornography addiction include cybersex, porn, online sex, and internet sex. Since pornography addiction behaviors are usually done in private, data is hard to find.
People struggling with porn addiction excessively view pornography. From this, negative consequences develop such as feeling isolated, neglecting important areas of daily life and creating relationship issues.5
Gambling Addiction
Gambling is legal across the United States, and many gamble for fun and recreation. When gambling crosses the line into excessive wagering, a process addiction may be developing.
Also known as problem gambling or gambling disorder (GD), this type of process addiction means that the person’s gambling habits put job, finances, or family life at risk. Many forms of gambling are easily accessible: casino games, slot machines, poker games, online gambling, and sports bets. If the following are present, the person could have a pathological gambling addiction:
- Places more and more bets
- Bets more money than first intended
- Chases losses by frequent betting over one’s ability to pay
- Feels irritable or aggressive when losing or can’t gamble
- Is preoccupied with gambling
The negative consequences of problem gambling can be life-changing. People in gambling disorder treatment talk about losing large amounts of money, legal problems, lost homes, bankruptcies, lost jobs, and divorces. Suicide risks are higher among people who struggle with gambling issues.6
Internet Addiction vs. Social Media Addiction
The internet is part of daily life for many Americans. According to the Pew Research Center, in the age group of 18 to 29, 81% of people report they go online every day. This includes:7
- 28% go online nearly constantly
- 45% go online a few times daily
- 9% go online once a day
- 8% go online a few times a week or less
Only 10% of Americans report they don’t use the internet
Handheld devices make it much easier for people to be connected to the internet. According to the Pew Research Center, 86% of Americans use mobile devices to connect to the internet. This includes those who are:7
- online every day – 92%
- online almost all the time – 32%
Internet Addiction
When individuals spend so much of their time online that it interferes with their daily lives, internet addiction may be present. A person needs help if going online or wanting to go online becomes more important than work, school, or loved ones, close relationships.
Social Media Addiction
Social media addiction differs from internet addiction in that it involves specific types of websites that are based on social sharing or, in some cases, lurking to see what everyone else is sharing. Constantly visiting sites like Facebook and Twitter are major signs that someone could have a social media addiction.
Many people like to pop in to see what’s the latest in their social sharing world, but when it starts to take up large amounts of time and impacts important relationships, it may be time to seek professional help.
Gaming Addiction
Gaming addiction is like social media addiction in that large amounts of time are spent on specific types of sites (gaming) that negatively impacts work, home, and family life. While games can be played offline, many popular games are played on the internet with teams and virtual environments.
Popular online games that can be addictive are:
- Fortnite
- World of Warcraft
- Guild Wars 2
- Final Fantasy 14
- Eve Online
- Black Desert Online
- Minecraft
- Star Wars: The Old Republic
The addiction to a fantasy world can become more important than real life. Unfortunately, gaming addiction can lead to an inability to connect with others, a lack of healthy relationships, difficulties at work or school, and neglecting personal health (not eating regularly or eating junk food often, little exercise).
Without treatment, many people struggling with gaming addiction can end up completely isolated, unable to function, and all their goals are geared to gaming accomplishments.
Food Addiction vs. Eating Disorders
Food-related disorders are especially difficult to unravel since we all must eat to survive. When a process addiction involves overeating (food addiction) or compulsive eating habits (eating disorders), eating is the person’s main focus in life.
Food Addiction
People who regularly overeat and cannot control their eating behaviors struggle with food addictions. The menu is typically high in fats, sugars, or salts. People with food addictions describe euphoria when they are eating their favorite (usually unhealthy) foods.
Also, food addiction can cause a tolerance to develop, which is also characteristic of substance use disorder. With food addiction, more and more favorite foods are needed to reach the euphoria the person is seeking. Negative impacts on self-esteem, damaged relationships, and health problems can come from food addiction.
Eating Disorders
Many different forms of diseases come under the term of eating disorders.
- Anorexia Nervosa: Based on eating behaviors, such as restricting the amount of daily calories, people with this disorder show a low body weight. They also have an overt fear of gaining weight, so they develop behaviors that interfere with weight gain.
- Bulimia Nervosa: This disorder is characterized by binge eating and then purging (vomiting the food soon after eating).
- Binge Eating Disorder: Recurrent episodes of eating large amounts of food in a short time are the hallmarks of BED. While individuals are in one of these frequent episodes, they report feeling they have no control over their behaviors as well as feelings of embarrassment, shame, and guilt. Some people with binge eating disorder may eat very fast even when not hungry.
Shopping Addiction vs. Kleptomania
Shopping Addiction
Kleptomania
- It is estimated that about 1.2 million people (6 per 1000 adult Americans) have kleptomania in the United States.9
- Kleptomania is thought to be the cause of about 5% of shoplifting.
- In 2002, the total shoplifting costs were estimated at $10 billion. At 5%, kleptomania would be responsible for $500 million in economic losses every year.9
Exercise Addiction
Exercise addiction involves excessive workouts that lead to negative effects on a person’s life. Exercise releases endorphins and dopamine that cause a sense of well-being. People with exercise addictions compulsively seek the high caused by the endorphins and dopamine. They are not improving their health, but rather are harming themselves. It’s estimated that 3% of adult Americans suffer from exercise addiction.10
- Excessive exercising that increases over time to obtain a buzz or high or sense of accomplishment.
- When the person can't exercise, he or she feels anxious, irritable, restless, and may have trouble sleeping.
- Attempts to stop or reduce workout time fails.
- A reasonably long exercise routine increases to an extended time consistently.
- A large amount of time is spent in the preparation, engagement, and recovery from exercise sessions.
- Other activities involving friends, family, or jobs, suffer because exercise consumes so much time.
Health Problems Associated with Process Addiction
- Sex Addiction: Venereal diseases, AIDs, unwanted pregnancies, risky sexual behaviors
- Internet, Social Media, and Gaming Addictions: Lack of exercise and poor eating habits can produce many different health issues.
- Food Addiction and Eating Disorders: Food addiction can create morbid obesity and its related health issues. Eating disorders can lead to a wide range of health problems and can be fatal.
- Exercise Addiction: Exercise addiction can cause cardiovascular and other health issues related to the excessive amount of stress on the body due to over-exercising.
Treatment for Process Addiction
Mental Health Treatment
Psychotherapy sessions, such as cognitive-behavioral therapy (CBT) can help people with behavioral addictions analyze the reasons behind their addictions. These sessions can also help them discover what triggers these behaviors and what helped control them in the past. Participants also learn coping skills to manage any compulsions and how to avoid relapse.
Medication Treatment with Naltrexone or Topiramate
Topiramate is an anticonvulsant drug that affects receptors in the brain. Research has shown that it helps treat problem gambling, kleptomania, and compulsive buying and internet addictions as well as helping reduce alcohol, cigarette and cocaine use.11
12-Step Programs
Diagnosing Process Addiction and Finding Help
If you or a loved one is struggling with a process addiction, with the right mental health treatment, a renewed and rewarding life that is free from addictions is possible. Talk with your doctor or a treatment center about the first step: a process addiction assessment.
Resources
- https://pubs.niaaa.nih.gov/publications/arh312/93-95.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499743/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945841/
- https://www.ncbi.nlm.nih.gov/pubmed/27114191
- https://www.ncbi.nlm.nih.gov/pubmed/30427214
- https://www.pewresearch.org/fact-tank/2019/07/25/americans-going-online-almost-constantly/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535651/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210598/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3164585/