The Behavioral Addictions is the first American Psychiatric Publishing title to explore the diagnosis and treatment of patients who suffer from behavioral addictions, extreme forms of which share specific characteristics with severe forms of substance use disorders. These characteristics include tolerance (the need to use the substance or perform the troublesome behavior at higher doses, or more and more frequently, in order to achieve the same effect); withdrawal (feelings of restlessness, irritability, and discontent following abrupt discontinuation of the substance or the behavior); obsessive thinking and planning that block out anything other than obtaining or engaging in the addictive agent or behavior; and accompanying external consequences in related to finances, health, interpersonal relationships, legal affairs, etc. Although not all behavioral addictions are currently recognized as such by DSM-5, both substances and behaviors can hijack a person's pleasure-and-reward brain circuitry, causing great suffering.
This case-based volume is practical and engaging and offers many features that make it not only informative but also accessible and entertaining:
Behaviors covered, both those widely recognized and those less commonly accepted, involve exercise, food, gambling, Internet gaming, Internet surfing, kleptomania, love, sex, shopping, work, tanning, and e-mailing/texting. Introductory chapters discuss the relationship of behavioral or process addictions to substance use disorders across many spheres, and they provide an overview of the behavioral addictions from neurobiological, theoretical, clinical, and forensic perspectives. Gambling disorder is now classified in DSM-5 as a behavioral addiction, lending credence to the construct of behavioral addictions and providing precedent for future consideration of other behavioral addictions, such as those highlighted in the volume. Each chapter focuses on a real-life case study of a patient with a behavioral addiction. Videos that accompany the volume demonstrate encounters between a clinician and a patient exhibiting an addiction. This puts material on assessment, treatment, etc. into a real-world context. Key points for review and multiple-choice questions are included at the end of each chapter.
Not simply an exaggeration of everyday social and personal ailments, these behavioral conditions present clinicians with unique and poorly researched challenges in everyday clinical practice. The Behavioral Addictions helps the reader to determine not only where to draw the line between healthy and unhealthy levels of participation in a behavior, but also how to intervene in ways that are therapeutic, effective, and evidence-based.
Michael S. Ascher, M.D., is a Clinical Associate in Psychiatry at the University of Pennsylvania, Perelman School of Medicine in Philadelphia, Pennsylvania. Petros Levounis, M.D., M.A., is Chair of the Department of Psychiatry at Rutgers New Jersey Medical School and Chief of Service at University Hospital in Newark, New Jersey.
