Transdiagnostic or Disorder Specific? Indicators of Substance and Behavioral Addictions Nominated by People with Lived Experience.

Hyoun S Kim,David C Hodgins,Benjamin Kim,T Cameron Wild

doi:10.3390/jcm9020334

Hyoun S Kim, David C Hodgins + Show 2 more

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https://doi.org/10.3390/jcm9020334

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Abstract

Using a transdiagnostic perspective, the present research examined the prominent indicators of substance (alcohol, cocaine, marijuana, tobacco) and behavioral (gambling, video games, sex, shopping, work, eating) addictions nominated by people with lived experiences. Specifically, we aimed to explore whether the perceived most important indicators nominated were consistent across the 10 addictions or differed based on the specific addiction. Additionally, we explored gender differences in the perceived most important indicators across addictive behaviors. A large online sample of adults recruited from a Canadian province (n = 3503) were asked to describe the most important signs or symptoms of problems with these substances and behaviors. Open-ended responses were analyzed among a subsample of 2603 respondents (n = 1562 in the past year) who disclosed that they had personally experienced a problem with at least one addiction listed above. Content analyses revealed that dependence (e.g., craving, impairments in control) and patterns of use (e.g., frequency) were the most commonly perceived indicators for both substance and behavioral addictions, accounting for over half of all the qualitative responses. Differences were also found between substance and behavioral addictions regarding the proportion of the most important signs nominated. Consistent with the syndrome model of addiction, unique indicators were also found for specific addictive behaviors, with the greatest proportion of unique indicators found for eating. Supplemental analyses found that perceived indicators across addictions were generally gender invariant. Results provide some support for a transdiagnostic conceptualization of substance and behavioral addictions. Implications for the study, prevention, and treatment of addictions are discussed.

Highlights

Transdiagnostic models of addictions are not new, having been proposed since the 1980s [1]
The aim of the present research was to examine whether the most important indicators nominated by people with lived experiences were consistent across the 10 addictions or differed based on the specific addiction
We aimed to examine whether the most important indicators nominated by people with lived experiences were consistent across the 10 addictions or differed based on the specific addiction

Summary

Introduction

Transdiagnostic models of addictions are not new, having been proposed since the 1980s [1]. Consistent with a transdiagnostic conceptualization, a growing number of empirical studies suggest that the etiological (e.g., onset), neurobiological (e.g., reward pathway), phenomenological (e.g., loss of control, craving), psycho-social (e.g., impulsivity, interpersonal difficulties), and clinical (e.g., treatment strategies) features of substance and behavioral addictions overlap more often than not (see [5,6] for reviews). Both substance and behavioral addictions are neurobiologically associated with desensitization of reward circuits, dysfunctions in executive functions, and strengthening of conditioned addiction cues [7]. Psychological processes such as high levels of impulsivity and emotion dysregulation have been robustly associated across both substance and behavioral addictions [6]

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