CLINICAL CHARACTERISTICS

• Addiction is a state of dependency on a chemical substance, especially on a drug such as alcohol, nicotine or caffeine, or a narcotic, such morphine or heroin, characterised by a strong physiological and/or psychological need and a compulsive inability to resist taking the drug despite anticipation of probable adverse consequences, withdrawal if there is an abrupt deprivation of the substance, and in some cases drug tolerance. However recently the term has come to encompass behavioural addictions, as well. For example gambling, exercise (gym) or internet use.
• DSM-V includes gambling disorder in a new category of behavioural addictions, recognising that it is similar to substance use disorders in many ways. Internet gambling disorder is also included under a special section encompassing disorders that need further research before being considered for inclusion in the main manual.
• • Mark Griffiths (2005) suggests there are six criteria that need to be met for a behaviour to be considered an addiction. These criteria were written for behavioural addictions but can also be applied to drug and other substances as well.
• What are the six criteria as suggested by Griffiths (2005)?

  • Salience
  • Mood modification
  • Tolerance
  • Withdrawal symptoms
  • Conflict
  • Relapse

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• Salience


  When the particular activity becomes the most important activity in the addict's life and dominates their thinking, feelings and behaviour
• Salience


  • Even if the person is not actually engaged in the addictive behaviour, they will be thinking about the next time they will be
  • 'If I wasn't actually gambling, I was spending the rest of my time working out clever little schemes to obtain money to feed my habit. These two activities literally took up all my time'
• Mood modification


  The subjective experience that people report as a consequence of engaging in the particular activity
• Mood modification


  • A nicotine addict may use cigarettes first thing in the morning to get the arousing 'nicotine rush' they need to get going for the day
  • By the end of the day, they may not be using nicotine for its stimulant qualities but may in fact be using nicotine as a way of distressing and relaxing
  • An addict will use the addiction as a way of self-medicating to cope with any problems they may be experiencing
• Tolerance


  The process whereby increasing amounts of the particular activity are required to achieve the former effects
• Tolerance


  • A heroin addict's need to increase the size of their 'fix' to get the type of feeling, the intense 'rush' that they once got from much smaller doses
  • Regular gamblers' heart rates decreased faster than non-regular gamblers, implying they needed to restart gambling more quickly to achieve the same level of arousal
• Withdrawal symptoms


  The unpleasant feelings, states and/or physical effects that occur when the particular activity is discontinued or suddenly reduced
• Withdrawal symptoms


  • Psychological symptoms like extreme moodiness and irritability
  • Physiological/physical symptoms like nausea, sweats, headaches, insomnia and other stress-related reactions
• Conflict


  • Conflicts between the addict and those around them (interpersonal conflict)
  • Conflicts within the individual themselves (intrapsychic conflict)
• Conflict


  • The addict may know that they want to cut down or stop engaging in the behaviour but may struggle to do so
  • Continual choosing of short-term pleasure and relief leads to disregard of adverse consequences and long-term damage, which in turn increases the apparent need for the addictive activity as a coping strategy
• Relapse - this refers to the tendency for repeated reversions to earlier patterns of particular activity to recur and, for even the most extreme patterns typical of the height of addiction, to be quickly restored after many years of abstinence or control.

  The classic example of relapse

  behaviour is in smokers who often give up for a period of time only to return to full-time smoking after a few cigarettes.
• Glenn Walters (1999) created characteristics of addiction known as the 4 'P's.

  Preoccupation is when the addict is engrossed by their addictive stimulus.

  persistes desse diting and con in the addictive

  Progression is continuing to engage in the addictive stimulus more and more as tolerance increases.

  Perceived is where the addict feels like they have lost control when in fact they may not have.
• Outlined above are the characteristics of addictive behaviour. According to Griffiths there are six criteria which need to be met in order to be classified with an addiction and Walters suggests the 4P's which should also be considered.