Blueprint For Behavioral Addiction Research Research Articles

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Can the emerging domain of behavioral addictions bring a new reflection for the field of addictions, by stressing the issue of the context of addiction development?

BackgroundThis paper is a commentary to the article entitled: “Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research”, by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015).Methods and AimsIn this manuscript, we commented on two aspects developed by the authors. Billieux et al. (2015) propose that the recent development of propositions of behavioral addiction is driven by an unwise application of an addiction model to excessive behaviors and rests on a confirmatory research strategy that does not question the psychological processes underlying the development of the conduct. They also show that applying a process driven strategy leads to a more appropriate description of the reality of the behavior and conduct, in particular by describing a variety of motivations for the excessive behavior, which is central to understanding the nature of the conduct. We believe that this new approach, which is fruitful to the emerging domain of behavioral addictions, could also apply to the domain of addictions in general. The latter is characterized by the application of a generic biological model, largely influenced by animal models, focusing on neurophysiological determinants of addiction. This approach may have decreased the attention paid to dimensions of addictions that are more specifically human. We will firstly briefly argue on the limitation of this neurophysiological addiction model for the field of excessive behavioral conducts. Secondly, we will argue for an approach centered on the differentiation of motivations and on the adaptive dimension of the behavior when it first developed and on the evocation of a transition where the conduct became independent of its original function.ConclusionsThe emerging domain of behavioral addictions, where no animal model has been developed so far, may bring a new reflection that may apply to the domain of addictions in general, with a specific attention to human questions.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. On functional and compulsive aspects of reinforcement pathologies.

BackgroundThis paper is a commentary to a debate article entitled: “Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research”, by Billieux et al. (2015).Methods and aimThis brief response focused on the necessity to better characterize psychological and related neurocognitive determinants of persistent deleterious actions associated or not with substance utilization.ResultsA majority of addicted people could be driven by psychological functional reasons to keep using drugs, gambling or buying despite the growing number of related negative consequences. In addition, a non-negligible proportion of them would need assistance to restore profound disturbances in basic learning processes involved in compulsive actions.ConclusionsThe distinction between psychological functionality and compulsive aspects of addictive behaviors should represent a big step towards more efficient treatments.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Excessive behaviors are not necessarily addictive behaviors.

Background and AimsThe commentary aims to provide clarity to the article “Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research.”MethodsWe provide another viewpoint for the important issues of behavior addiction.ResultThe course of behavior addiction should be further studied. The criteria of withdrawal and tolerance of behavior addiction are ill-defined and need to be further evaluated.ConclusionsThe etiology, course, presentation, and functional impairment of behavior addiction should be validated by evidencebased data before being defined as a disorder.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. The diagnostic pitfalls of surveys: If you score positive on a test of addiction, you still have a good chance not to be addicted.

Background and AimsSurvey-based studies often fail to take into account the predictive value of a test, in other words, the probability of a person having (or not having) the disease when scoring positive (or negative) on the given screening test.MethodsWe re-visited the theory and basic calculations of diagnostic accuracy.ResultsIn general, the lower the prevalence the worse the predictive value is. When the disorder is relatively rare, a positive test finding is typically not useful in confirming its presence given the high proportion of false positive cases. For example, using the Compulsive Buying Scale (Faber & O’Guinn, 1992) three in four people classified as having compulsive buying disorder will in fact not have the disorder.ConclusionsScreening tests are limited to serve as an early detection “gate” and only clinical (interview-based) studies are suitable to claim that a certain behaviour is truly “pathological”.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research.

This commentary supports the argument that there is an increasing tendency to subsume a range of excessive daily behaviors under the rubric of non-substance related behavioral addictions. The concept of behavioral addictions gained momentum in the 1990s with the recent reclassification of pathological gambling as a non-substance behavioral addiction in DSM-5 accelerating this process. The propensity to label a host of normal behaviors carried out to excess as pathological based simply on phenomenological similarities to addictive disorders will ultimately undermine the credibility of behavioral addiction as a valid construct. From a scientific perspective, anecdotal observation followed by the subsequent modification of the wording of existing substance dependence diagnostic criteria, and then searching for biopsychosocial correlates to justify classifying an excessive behavior resulting in harm as an addiction falls far short of accepted taxonomic standards. The differentiation of normal from non-substance addictive behaviors ought to be grounded in sound conceptual, theoretical and empirical methodologies. There are other more parsimonious explanations accounting for such behaviors. Consideration needs to be given to excluding the possibility that excessive behaviors are due to situational environmental/social factors, or symptomatic of an existing affective disorder such as depression or personality traits characteristic of cluster B personalities (namely, impulsivity) rather than the advocating for the establishment of new disorders.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

This commentary proposes a complementary perspective to that developed by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015). The addiction-as-disease approach tends to sideline explanatory factors of a psychosocial, cultural, political, or historical nature. I therefore suggest taking into account not only the personal characteristics (loss of self-control, impulsivity) related to the disease model, but also the social determinants of addictive behaviors (weak social ties, social exclusion, hyperindividualism, poverty, unemployment, etc.). Moreover, the disease model of addiction removes addictive behaviors from the cultural and historical contexts that shape them. I argue that the cultural and historical reasons for which certain factors (such as loss of self-control) became so important in the explanation of addictive behaviors should be more thoroughly considered.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. On the slippery slopes: The case of gambling addiction.

Billieux et al. (2015) propose that the recent proliferation of behavioral addictions has been driven by deficiencies in the underlying research strategy. This commentary considers how pathological gambling (now termed gambling disorder) traversed these challenges to become the first recognized behavioral addiction in the DSM-5. Ironically, many similar issues continue to exist in research on gambling disorder, including question-marks over the validity of tolerance, heterogeneity in gambling motives, and the under-specification of neuroimaging biomarkers. Nevertheless, I contend that the case for gambling disorder as a behavioral addiction has been bolstered by the existence of clear and consistent functional impairment (primarily in the form of debt), coupled with the development of a public health approach that has given emphasis to product features (i.e. the structural characteristics of gambling forms) as much as individual dispositions (the ‘addictive personality’).

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Problems with atheoretical and confirmatory research approaches in the study of behavioral addictions.

Background and AimsThis commentary is written in response to a paper by Billieux, Schimmenti, Khazaal, Maurage and Hereen (2015) published in the Journal of Behavioral Addictions.MethodsIt supports and extends the arguments by Billieux, Schimmenti et al. (2015): that the study of behavioral addictions too often rests on atheoretical and confirmatory research approaches. This tends to lead to theories that lack specificity and a neglect of the underlying processes that might explain why repetitive problem behaviors occur.ResultsIn this commentary I extend the arguments by Billieux, Schimmenti et al. (2015) and argue that such research approaches might take us further away from conceptualizing psychiatric diagnoses that can be properly validated, which is already a problem in the field. Furthermore, I discuss whether the empirical support for conceptualizing repetitive problem behaviors as addictions might rest on research practices that have been methodologically biased to produce a result congruent with the proposal that substance addictions and behavioral addictions share similar traits.ConclusionsI conclude by presenting a number of ways of going forward, chief of which is the proposal that we might wish to go beyond a priori assumptions of addiction in favor of identifying the essential problem manifestations for each new potential behavioral addiction.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Defining and classifying non-substance or behavioral addictions.

Multiple controversies exist currently in the field of behavioral addictions. The opinion article by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015) proposes an approach to considering which behaviors might be considered as foci for addictions. The article raises multiple important points that foster further dialog and highlight the need for additional research. Given that how specific behaviors are considered from diagnostic and classification perspectives holds significant public health implications, targeting and eliminating current knowledge gaps relating to behavioral addictions is an important undertaking.

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research.

This commentary considers a recent article on how the proliferating use of atheoretical, confirmatory and diagnosis driven research approaches is resulting in the over-identification of behavioral addictions. In response to the original article, I reflect on the timeliness and value of its observations and expand on a central point it raises: The importance of thinking beyond diagnostic frameworks in developing a comprehensive understanding of addictive behaviors and associated treatments.

Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research.

BackgroundBehavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction.Methods and aimIn this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions.ResultsBoth methodological and theoretical shortcomings of these studies were discussed.ConclusionsWe suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.