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Behavioral Addiction.pptx
- 1. OVERVIEW OF BEHAVIORAL ADDICTION BY MOSTAFA MAHMOUD ELSABBAN ASSISTANT LECTURER OF PSYCHIATRY AL AZHAR UNIVERSITY-DAMIETTA
- 2. CASE VIGNETTE • THE 13 Y OLD GIRL WANTS TO ACCESS THE INTERNET USING HER FATHERS LAPTOP COMPUTER. • SUDDENLY, SHE IS CONFRONTED WITH A HIDDEN FOLDER CONTAINING THOUSANDS OF PORNOGRAPHIC IMAGES. • WITHIN HER, A WORLD IS BREAKING APART. HER FATHER WHOM SHE HAS ADMIRED, THE GOOD TEACHER, HOW DOES IT FIT WITH SUCH MATERIAL. • SHE STARTED TO CRY ALL THE DAY , STOP EATING, SKIP SCHOOL. • SHE SMASHES THE LAPTOP BY THROWING IT OUT OF THE WINDOW. • THE WHOLE FAMILY IS IN A DRAMATIC CRISIS. IT IS IN THIS
- 4. BEHAVIORAL ADDICTIONS With forensic implications • Gambling, • Internet Gaming, • Internet Addiction, • Kleptomania, • Pyromania • Sexual Addiction and • Buying Addiction without obvious forensic implications • Compulsive Exercising, • Compulsive Eating, • Compulsive Tanning, • Trichotillomania and • Excoriation [skin pulling])
- 7. IS IT A DISEASE OR BEHAVIORAL PROBLEM? • DIAGNOSTIC CATEGORY FOLLOWING ICD-10 / DSM-5 UNCLEAR • OCD? • DISORDERS OF IMPULSE CONTROL? • NON-SUBSTANCE ADDICTION? KIMBERLY S. YOUNG
- 8. INTERNET ADDICTION DISORDER (IAD) PROPOSED DIAGNOSTIC CRITERIA • A MALADAPTIVE PATTERN OF INTERNET USE, LEADING TO CLINICALLY SIGNIFICANT IMPAIRMENT OR DISTRESS AS MANIFESTED BY THREE (OR MORE) OF THE FOLLOWING OCCURRING AT ANY TIME IN THE SAME 12-MONTH PERIOD: 1. INTERNET IS OFTEN ACCESSED MORE OFTEN OR FOR LONGER PERIODS OF TIME THAN WAS INTENDED. 2. THERE IS A PERSISTENT DESIRE OR UNSUCCESSFUL EFFORTS TO CUT DOWN OR CONTROL INTERNET USE. 3. A GREAT DEAL OF TIME IS SPENT IN ACTIVITIES RELATED TO INTERNET USE Author: Ivan Goldberg, M.D.
- 9. INTERNET ADDICTION DISORDER (IAD) DIAGNOSTIC CRITERIA 4. CRAVING, OR A STRONG DESIRE OR URGE TO USE THE INTERNET. 5. RECURRENT USE OF THE INTERNET RESULTING IN A FAILURE TO FULFILL MAJOR ROLE OBLIGATIONS AT WORK, SCHOOL, OR HOME. 6. IMPORTANT SOCIAL, OCCUPATIONAL, OR RECREATIONAL ACTIVITIES ARE GIVEN UP OR REDUCED BECAUSE OF INTERNET USE. 7. RECURRENT INTERNET USE IN SITUATIONS IN WHICH IT IS PHYSICALLY HAZARDOUS. 8. TOLERANCE 9. WITHDRAWAL
- 10. COMORBIDITIES • A REVIEW OF THIS LITERATURE IDENTIFIED 20 STUDIES: 100% with ADHD 75% with Depression 60 % with OCD 50 % with Anxiety (Carli et al., 2013)
- 11. DIFFERENCES BETWEEN MEN AND WOMEN • MEN • KICK THROUGH VISUAL MATERIAL • SEXUAL EXCITEMENT WITH MASTURBATION. • TENDENCY TOWARDS VIOLENT AND ABASING CONTENT. • WOMEN: • KICK THROUGH COMMUNICATION (CHAT). • ROMANTIC STORIES AND IMAGES • SEXUAL EXCITEMENT IS SECONDARY.
- 12. 1. Visual Stimulus 2. Sexual Excitement 3. Dopamin – „Happiness“ 4. Adaptation – Desire for more and stronger stimuli 5. Loss of control Limbic System frontal brain BRAIN FUNCTIONS IN PORN ADDICTION 1 2 3 4 5 Genital Stimulation 2
- 15. PSYCHOPHARMACOLOGY CONCLUSION: • MEDICATION (UNFORTUNATELY) IS NOT A SOLUTION. • EXCEPT IF ASSOCIATED PSYCHIATRIC DISORDER. Antidepressan ts Opioid Receptor Antagonists Mood stabilizers Antipsychotic s
- 17. CONCLUSION • DEVELOPING A STANDARD OF PRACTICE FOR THE TREATMENT OF IA IS STILL IN ITS INFANCY. • BECAUSE IA IS NOT A CURRENTLY ACCEPTED DIAGNOSIS IN DSM-5, WE DO NOT YET KNOW IF IA IS EVEN A VALID DISEASE STATE. • CURRENT APPROACHES RELY MAINLY ON ANECDOTAL EVIDENCE AND A PRELIMINARY UNDERSTANDING OF SOCIOBIOLOGICAL CAUSAL FACTORS OF THIS PHENOMENON.
- 18. CONCLUSION • EXISTING LITERATURE AND CLINICAL EXPERIENCE SUGGEST THAT IN DESIGNING A TREATMENT PROGRAM FOR THESE PATIENTS, SEVERAL ELEMENTS ARE ESSENTIAL: • FIRST, TREATMENT OF PSYCHIATRIC COMORBIDITIES SUCH AS ANXIETY AND DEPRESSION AND OTHER SUBSTANCE USE DISORDERS IS AN IMPORTANT ELEMENT. • SECOND, THERE IS GOOD EVIDENCE THAT A CBT PROGRAM INCORPORATING ELEMENTS OF RESTRUCTURING DISTORTED THINKING AND PROMOTING ACTIVE BEHAVIORAL CHANGE CAN BE EFFECTIVE. • THIRD, INVOLVING FAMILY AND OTHER SOCIAL SUPPORT NETWORKS CAN BE USEFUL AND EFFECTIVE
- 19. THANK