Addictions.2

Addictions.2 - Pathological Gambling Sexual Addiction '...

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Unformatted text preview: Pathological Gambling Sexual Addiction ' Kinsey and colleagues developed the concept of total sexual outlet (TSO), which corresponded to the total number of. orgasms achieved by any ‘ Pathological gambling is CIASSlf‘lEd as combination of sexual outlets per week an Impulse Control Disorder Not Elsewhere Classified in the DSNl-IV- TR ° 7.6% of American males reported a mean total sexual outlet per week above 7 for at least 5 years ‘ Kafka et al. proposed that hypersexual behavior could be ° Described as a maladaptive pattern or characterized by T505 of at least 7 times per week. gambling behavior that may be associated with serious psychosocial and financial problems ' "Sexual Disorder Not Otherwise Specified (coded 302.90)" was reformulated as follows: Distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used. Tolerance and Withdrawal Sexual Addiction vs 0CD * Excessive nonparaphilic sexual behavior is marked by repetitive thoughts, described as intrusive, repeatedly experienced, generally associated with anxiety or tension which are characteristic of obsessional thoughts previously described in 0CD. t Tolerance is operationalized as gambling with increasing amounts of money in order to achieve the desired subjective eH‘ect or that the same level of gambling leads to a diminished subjective response ‘ Moreover, sexual "compulsions," while initially resisted, are enacted to reduce anxiety and are often followed by feelings of distress. ‘ Features of withdrawal: becoming anxious or irritable when quitting or cutting down on Impulse Control Disorder ‘ Characterized by the failure to resist an impulse, drive, or temptation to commit an act that is harmful to oneself or others ‘ Marked by an increased sense of tension or arousal prior to the behavior, a sense of gratification or relief during the behavior, and feelings of guilt following the act ' The impulsive component (e.g., pleasure, arousal, or gratification) could be responsible for the initiation of the cycle while a compulsive component could be involved in the persistence of the behavior Goodman Proposed Criteria A. Recurrent failure to resist impulses to engage in a specified sexual behavior; B. Increasing sense of tension immediately prior to initiating the sexual behavior: C. Pleasure or relief at the time of engaging in the sexual behaviour; D. At least five of the following criteria: (I) Frequent preoccupations with sexual behavior or with activity that is preparaton to the sexual behavior; (2) Frequent involvement in sexual behavior to a greater extent or over a longer period than intended; Addiction The addictive component of excessive nonparaphilic sexual behavior was first described by Orford who made a parallel between this disorder and substance addiction. ' Similarities between sexual addiction and chemical addiction: ‘ Escalation of sexual activity as the disorder progresses ‘ “Withdrawal symptoms such as depression. anxiety. rumination. and guilt related to a reduction of sexual activities ‘ Difficulties to stop or reduce the frequency of sexual activities ' Increased amount of time spent in seeking out potential partners. reduction of other activities. and maintenance of sexual behavior despite knowledge ofthe potential adverse consequences Goodman Proposed Criteria (5) Repeated efforts to reduce. control. or stop sexual behavior; (4) A great amount of time spent in activities necessary for engaging in sexual behavior. or for recovering from its effects: (5) Frequent involvement in sexual behavior when the subject is expected to fulfill occupational, academic. domestic, or social obligations; (6) Important social. occupational, or recreational activities given up or reduced because of the behavior; (7) Continuation of the behavior despite knowledge of having a persistent or recurrent social, financial. psycho- logical, or physical problem that is caused or exacerbated by the sexual behavior; Goodman Proposed Criteria Treatment ‘ (8) Tolerance: need to increase the intensity or frequent)r ofthe sexual 0 Due to the embarrassment that sexual addiction behavior in order to achieve the desired effect. or diminished ell'ccts . l l k obtained with sexual behavior of the same intensity; Patients may 51-1 er; they rare y Spontaneous y 566 medical advxce ' (9) Restlessness or irritability if unable to engage in sexual behavior. ‘ E. Some symptoms have persisted for at least one month, or have occurred repeatedly over a longer period of time. * Another major difficulty arises from the lack of standardized criteria S es tag Love Addiction ' Some evidence points to an onset during adolescence with a progressive course in four stages: 9 Love Passion ' (l) preoccupation 0 Love Addiction ’ (2) ritualization ' Sex and Love Addicts Anonymous ' (3) gratification , (4) despair * Comorbidities The Honeymoon Phase: Getting High on Love versus Getting Getting High on Love High on Substance * Unrestrained Desire and Sexual Pleasure ‘ L0"? inebriafim- ‘he honeymoon phase of ‘ An Emotional Exacerbation amorous ecstasy that initiates the attachment to a ' Feeling of euphoria and a joyful outlook on life love object, shows numerous similarities with ‘ Emotional dependence acute substance _ I _ . intoxication (getting ' Emononal labllity IS extremely strong "high") The Honey'fnoon Phase; Absence of Loved One versus Getting High on Love Substance Withdrawal ‘ The absence. of the loved person has neuropsychological ’ Cognitive Mechanism, driven by a powerful manifestations similar to the symptoms of substance motivation Withdrawal * Focussed attention (fixation) ' Negative mood ’ Strategy ‘ Suffering and sensations of emptiness ‘ Intense surge of energy ' Sleep disturbance ‘ Pervasive memories ‘ Cognitive preoccupation with seeking and meeting the other ‘ Invasive thought processes ’ Craving for this other Cognitive and Emotional Functioning in " Love Addicts" A life formerly so fulfilled and colorful now seems empty, grey, unattractive, and uninteresting. Anhedonia Loss of relationships External Cues Denial Compulsive Buyers * Compulsive buyers experience repetitive, irresistible, and overpowering urges to purchase goods * Availability of the Internet retail environment may promote compulsive buying * Strongly focus on the buying process itself 9 More interest in the acquisition than in possession or use of the item purchased Proposed Criteria ’A maladaptive or pmblemanc pattern of love I‘d-11an leading to clinically significant impairment or distress. as manifested by three (or more) of the follim'ing. (occurring at any time in the same 127 month period for the hrs: lite critens). (source, I)S.\i~l\')4 1. Existence of: charxlenzed withdrawal syndrome in the absence of the losed one. significant sufi'enng and a compulsive need for the other. 2. Considerable amount 05 mm: spent on this relation (in reality or in thought). 3. Reduction in important social, professional. or leisure Actinties. 4. Persistent desire or fruitless efforts to reduc: or control his relation. 5. Pursuit of the relation despite the existence of problems created by this relation. 6. Existence of attachment dimculnes (see 3.5. for more clarification). as manifested by either of the followuig (a) repeated exalted amorous relationships vn'thout any durable period of attuhment, (b) repeated painful amorous relationships. characterized insecure attachment." Intoxication and Withdrawal ‘ 70% of patients presenting with compulsive buying described buying as "a high," "a buzz," "a rush,” ‘ Compulsive buyers consider that they miss important occasions to buy items that will not be available again Adverse Consequences ’ Substantial financial debts ' Legal problems t Psychological distress ’ Interpersonal conflict. and marital conflict ' Depressed compulsive buyers do not seek sales, use loans, or change their purchase choices significantly more than others McElroy's et al. diagnostic criteria for compulsive buying Inappropriate preoccupations with buying or shopping. or inappropriate buying or shopping impulses or behavior. as indicated by at least one of the following: Frequent preoccupations with buying or impulses to buy that are experienced as irresistible. intrusive. and/or senseless Frequent buying of more than can be afforded. Frequent buying of items that are not needed. or shopping for longer periods of time than intended The buying preoccupations. impulses. or behaviors cause marked distress. are time-consuming. significantly interfere with social or occupational functioning. or result in financial problems (e.g., indebtedness or bankruptcy) The excessive buying or shopping behavior does not occur exclusively during periods of hypomania. or mania ...
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This note was uploaded on 08/05/2011 for the course PSYC 179 taught by Professor Koob during the Summer '08 term at UCSD.

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Addictions.2 - Pathological Gambling Sexual Addiction '...

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