Causes
Neither scientists nor mental health experts know exactly what causes behavioral addictions, although the latest research does provide evidence for the possibility of a genetic role. A variant of the NRXN3 gene, previously linked to smoking, drug, and alcohol addictions, has also been linked to impulsivity in men.
This link does not mean the gene causes behavioral addictions, but it can set the stage for their development when combined with other social, psychological, cultural, and emotional factors. Men are at least twice as likely as women to become dependent on drugs and alcohol, increasing men’s vulnerability to sex, gambling, and Internet addictions as well, as they share a high comorbidity rate.
In general, behavioral addictions among men have been increasing as society has changed. The proliferation of computer games, social networking sites, and pornography on the Internet make these activities prime targets for abuse. The growing availability of casinos and promotion of lotteries and sports betting have resulted in an increase in pathological gambling. The emphasis on physical attractiveness has resulted in more exercise addictions, while easy access to credit cards, especially among college-age youth, has led to more shopping addictions.
Risk Factors
Studies have shown that men between age sixteen and twenty-five represent the most vulnerable age group for many behavioral addictions, including Internet, gambling, computer gaming, shopping, sex, and exercise addictions, although an addiction can begin at any age. Also vulnerable are men with substance abuse addictions and men with depression, anxiety, perfectionism, low self-esteem, and poor social skills.
The greatest risk for an exercise addiction, usually bodybuilding or running, can be found among men who are borderline narcissistic or who have an eating disorder. At high risk for a gambling addiction are men who identify pathologically with wealth. Other risk factors include child abuse, often a factor in sex addictions, and chronic unemployment, a factor especially in computer gaming and Internet addictions. Men with physical disabilities might also be at a higher risk for any of the sedentary addictions, such as computer gaming or television watching.
Screening and Diagnosis
Guidelines for diagnosing pathological gambling are provided in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders . A variety of screening tools are available to help with the diagnosis of other addictions. These tools include the running addiction scale, exercise dependence scale, Internet addiction diagnostic questionnaire, Internet addiction test, workaholism battery, compulsive buying scale, sexual addiction screening test, and online cognition scale.
In addition to conducting tests, the mental health professional usually conducts a physical exam of the client and, in some cases, talks to family members or obtains legal records for additional information. While a diagnosis is usually only made after a thorough examination, sometimes it depends on one criterion: the inability of the client to limit his behavior to within a normal, healthy range.
Symptoms
As a person becomes addicted to a behavior or activity, the initial sense of pleasure or euphoria, similar to that induced by drugs or alcohol, often gives way to pain or a variety of negative thoughts and emotions. In some cases, the activity actually alters the chemistry of the body so that the person becomes both physically and psychologically dependent. When withdrawal is attempted, the addict may experience mood swings, insomnia, depression, headaches, and other physical or emotional symptoms.
Symptoms also may include the inability to perform satisfactorily at work or to maintain regular hours. Many addicts end up losing their jobs because of repeated absences or tardiness. Divorce, losing custody of children, and destroying friendships are also common among addicts.
Compulsive gamblers and shoppers usually end up with devastating financial problems. Exercise addicts often have prolonged pain and may have had multiple physical injuries or surgeries that would normally have convinced a nonaddict to stop the activity. Sexual addictions often result in sexually transmitted diseases and in unintended pregnancies. Internet and computer game addictions cause eating and sleep disorders, vision problems, headaches, and hygiene issues related to not bathing or using the toilet regularly. Suicide is prevalent among men with severe behavioral addictions, as the shame, guilt, financial problems, and other woes are often too difficult to handle.
Treatment and Therapy
Treatment for a behavioral addiction often involves many steps. There are no miracle medications. Finding the underlying cause of the problem is key to a successful treatment plan.
A behavioral addiction can sometimes be a symptom of, or exist alongside, a mental disorder or illness, such as depression, bipolar disorder, or an obsessive-compulsive disorder. In those cases, pharmacological intervention is the normal course and would take precedence over treating the behavioral addiction. Psychotherapy will help uncover any repressed attitudes or child abuse that can be at the root of an addiction.
In many cases, the standard form of treatment is a twelve-step program similar to the model conceived by Alcoholics Anonymous or individual cognitive-behavior therapy (CBT) administered by a mental health expert. Family or couples therapy also is included when relevant.
CBT and the related twelve-step programs explore the negative or maladaptive thoughts, or cognitions, which are often the source of an addiction. For example, gambling addicts usually place an abnormally high value on personal wealth, whereas compulsive shoppers tend to believe their identities are closely associated with consumer goods. CBT will also confront the shame and denial often associated with addictions and help a man to ask for forgiveness from the people he has hurt. Most therapy programs also include an educational component to teach relevant skills, such as good nutrition or financial management.
Prevention
A man can prevent a behavior or activity from becoming an addiction by maintaining a healthy and balanced lifestyle and remaining vigilant when too much time, energy, or attention is focused on one particular activity. A balance between sedentary activities and sports, and between work and leisure, is important, as is nurturing happy, productive relationships and pursuing a fulfilling career.
Bibliography
Benson, April Lane, ed. I Shop, Therefore I Am: Compulsive Buying and the Search for Self. Northvale: Aronson, 2000. Print.
Clark, Neils, and P. Shavaun Scott. Game Addiction: The Experience and the Effects. Jefferson: McFarland, 2009. Print.
Grant, Jon E., et al. “Introduction to Behavioral Addictions.” American Journal of Drug and Alcohol Abuse 36.5 (2010): 233–41. Print.
Hartston, Heidi. “The Case for Compulsive Shopping as an Addiction.” Journal of Psychoactive Drugs 44.1 (2012): 64–67. Print.
Kerr, John H., Koenraad J. Lindner, and Michelle Blaydon. Exercise Dependence. New York: Routledge, 2007. Print.
Lee, Chris. “This Man Is Addicted to Sex.” Newsweek 158 (2011): 48–55. Print.
Ley, David J. The Myth of Sex Addiction. New York: Rowman, 2012. Print.
Morgan, John F. The Invisible Man: A Self-Help Guide for Men with Eating Disorders, Compulsive Exercise, and Bigorexia. New York: Routledge, 2008. Print.
Pappas, Stephanie. “Male Impulsivity and Addiction Linked to One Gene.” 18 Nov. 2011. Web. 2 Apr. 2012. http://www.livescience.com/17095-men-impulsivity-addiction-gene.html.
Skolnik, Sam. High Stakes: The Rising Cost of America’s Gambling Addiction. Boston: Beacon, 2011. Print.
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