behavioral addictions: are they really addictions? thomas e. legere, ph.d

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Behavioral Addictions: Are they Really Addictions? Thomas E. Legere, Ph.D. Slide 2 How do we Decide? Slide 3 Old School: DSM Slide 4 We Need a NEW Model! From THREE Sources Slide 5 Source #1: The DSM Slide 6 Source #2: What Those Who Suffer From the Disease Say Slide 7 Source #3: Neurobiology Slide 8 Three TYPES of Addictions Slide 9 I. HARD Addictions: Alcohol & Drugs Slide 10 II. SOFT Addictions: Nicotine & Caffeine Slide 11 III. BEHAVIORAL Addictions Slide 12 Three Levels of Addiction: Mild Mild Moderate Moderate Severe Severe Slide 13 Soft Addictions: Soft for a Reason Slide 14 Proposed Behavioral Addictions: Sex Sex Love Love Gambling Gambling Exercise Exercise Eating Eating Slide 15 What Makes them Real Addictions (or not)? Slide 16 Need Common Criteria for Hard Addictions & Behavioral Addictions Slide 17 Honestly: The DSM is Not Buying Behavioral Addictions Slide 18 DSM: Compulsive Disorders Compulsive Disorders Pathological Behavior Pathological Behavior Eating Disorders Eating Disorders Slide 19 Twelve Integrated Criteria (DSM, Experience, Neurobiology) Slide 20 1. Pleasure Pathway In the Brain Slide 21 2. Same Brain Chemicals Involved Dopamine Gaba Dopamine Gaba Serotonin Glutamate Serotonin Glutamate Endorphins Cortisone Endorphins Cortisone Norepinephrine Corticotrophin Norepinephrine Corticotrophin Epinephrine Histamine Epinephrine Histamine Enkephalins Anandamide Enkephalins Anandamide Acetylcholine Acetylcholine Slide 22 3. Tolerance Slide 23 4. Use to Intoxication: I Cant Stop! Slide 24 5. Obsessive Dimension Slide 25 6. Denial Slide 26 7. Continued Use Despite Adverse Consequences Slide 27 8. Progressive Escalation of Intake and Problems Slide 28 9. Repeated Attempts To Control Use Slide 29 10. Withdrawal Slide 30 11. Incurable (Only Remission) Slide 31 12. Effectiveness of 12 Step Program