Exploring Various Process Addictions: Sex, Internet, and Gambling - Dissertation Example

?Introduction Numerous definitions of addiction have been developed in the history of the condition. However, Freimuth (2005: 38) s that addiction instils a mechanism in an individual where a behaviour that can serve both the purpose of producing pleasure and providing an escape from unpleasant internal events is entrenched. The resulting behaviour becomes difficult to control and the affected person feels a sense of powerlessness in attempting to cease from the habit. Other characteristics of addiction include continuation of the habit in spite of the apparent risks to health, social and economic aspects of the individual (Young, 1998). In the contemporary society, the growing rate of addiction to various substances and activities is one of the most formidable challenges the world is facing. Chemical, sex, gambling and internet are some of the most common types of addictions in the society. This paper explores the various process addictions focusing on sex, gambling and internet and comparing them with chemical addiction. Overview of process and chemical Addictions Since time immemorial, addiction has been associated with dependence and consumption of drugs and drinks. Research on substance addiction such as alcohol, cocaine and opiate drugs has been the subject of numerous studies, eliciting diverse as well as congruent findings. Volkow (2005: p49) argues that substance addictions are often associated with a perceived loss of control by the users, a condition attributed to the potent nature of the addictive substance or psychological craving that the substance triggers in the body. Dependency has been noted in other addictive activities that do not involve ingestion of drugs and other chemical substances that cause addiction. Dependency on sex, the internet, gambling, work, computer games and other habits are widespread in the society and have become addictive like chemical substances such as drugs. According to Aston- Jones and Harris (2004), drug or chemical dependency is a medical problem. Chemical addiction is characterised by compulsive use of drugs in spite of the negative consequences they inflict on the person’s health and social economic wellbeing (Berman and Siegel, 1999). The diagnostic and statistical manual (DSM -IV) lists seven behaviours that characterise individuals with addiction. These include tolerance to a psychoactive substance and withdrawal symptoms after access to an addictive substance or activity. The third behaviour involves taking larger quantities of the substance, or extending the use for a longer period than the initial intentions. Fourthly, people dependent on substances or other activities have persistent desires to stop or control the habit, but their attempts to cease are usually unsuccessful (APA, 2000: p38). The fifth characteristic of dependency is spending a lot of time in the use of the substance or in activities, which facilitates the availability of the substance or activity. Consequently, the affected person’s attendance to other important activities such as occupation, social interactions and leisure is greatly reduced or given up altogether. The seventh and final characteristic of substance dependence is persistent use, although the person is knowledgeable on the negatives effects that the drugs influence their health, social and economic state (APA, 2000: pp38-57). . The diagnostic and statistical manual holds that people with an addictive problem demonstrate at least three of the aforementioned characteristics (APA, 2000: p62). People addicted to chemical substances such as drugs have constant craving and obsession for the substance (Shotton, 1991). Therefore, the person uses the substance more often than necessary in order to achieve a continuous state of intoxication. In addition, obsession with drugs reduces the interests and motivation for engaging in other normal activities leading to social isolation, and neglecting personal hygiene. Continuous use creates tolerance of the substance in the body and consequently, the person experiences withdrawal symptoms when the supply of the drug is curtailed (Ladouceur, et al 2002: 107). Research on drug and process addiction has been approached on diverse approaches, including environmental, sociological and developmental perspectives. In addition, genetic composition of an individual, life experiences and the inherent toxic characteristics of the abused substances has been studied (Michel, and Koob, 2007). Michel and Koob (2007: 379) classified the perspectives into two broad categories, namely the drug focused and individual centred approaches. Drug centred perspective focuses on the pharmacological and intrinsic properties of the abused drug. This includes the various mechanisms through which the drugs work in the body, from functional to molecular levels. In addition, pharmacological approach investigates the characteristics of the abused drug, to establish the specific and general properties of various active components of the substances. Moreover, it pharmacological approach investigates the influence that the use of the drug imparts on the user. This includes the mechanism and duration of inducing dependence on the chemical substance (Michel and Koob, 2007). Individual focused approach focuses on the individual characteristics of the addict and the developmental aspects that influences or determines a person’s propensity to dependency (Piazza and Le Moal, 1998). According to Berman, and Siegel (1999), different people have various resilience and vulnerabilities levels in respect to abuse of drugs. These disparities could arise from different genetic composition, where possession of particular genes increases the vulnerability or resilience to abuse or addiction of particular drugs. Moreover, environmental factors play a major role in influencing an individual towards drug dependence and abuse (Michel, and Koob, 2007: 389). This approach implies that particular environment encourage or increase the vulnerability of a person to use drugs and therefore changing the surroundings could play a major role in controlling or exacerbating drug dependence. Shotton (1991) classified individual focused approach into three categories, namely psychiatric, psychodynamic, and self-regulation perspectives. In psychiatric view, Brechara, (2005) argues that drug and process addiction is considered as an ailment that gradually develops from impulsion to compulsion. Disorders associated with impulse control are characterized by mounting feelings of excitement prior to undertaking the impulsive activity. When the person is in the process of undertaking the act, he or she experiences a sense of satisfaction, pleasant emotion or relief. However, once the activity is completed, the person relapses to feelings of guilt, remorse, or may not experience such feelings. Compulsion on the other hand is characterised by intermittent and relentless thoughts, which manifest themselves in form of obsession. These obsessions towards a drug or an activity create nervousness and tension, which motivate the individual to commit the compulsive act repetitively in order to reduce or eliminate the accumulated stress (Michel and Koob, 2007: 385-92) The transition of a person using drugs from impulsive to compulsive behaviour is aptly elaborated in behavioural theory, particularly positive and negative reinforcement. Positive reinforcement is associated with the impulsive disorder whereby the person experiences satisfaction or gratification while using a drug, engaging in an activity such as gambling, or sex. Negative reinforcement arises in compulsive control behaviour whereby the person experiences a relief from stress or nervousness after committing or engaging in the act repetitively (Brian and Peter 2005). In relation to drug and process addiction, psychodynamic perspective focuses on the factors contributing to dependency. Psychodynamic theory emphasizes on the critical role that unconscious force such as environment, and socialization play in influencing the behaviour of an individual towards dependency (Brian and Peter 2005). According to Di Clemente (2003), psychodynamic approach to an individual’s vulnerability to addiction is founded on various factors, including developmental challenges, emotional instability, and other aspects that undermine the ego and self-perception of an individual. In relation to drug and some process addictions, disturbed emotions and self-preservation coupled with low self-esteem and chaotic interpersonal relationships motivate the affected individuals to take drugs as a form of self-medication to cope with the unpleasant feelings (Carnes, Murray, and Charpentier, 2005). Similarly, certain disorders such as alexithymia inhibit the affected person from expressing their feelings or emotions, necessitating the use of drugs to alleviate the condition (Michel and Koob, 2007). To address these conditions and encourage expression of unpleasant feelings, specific drugs are normally prescribed to manage particular symptoms. For instance, Craig (1995) argues that opiate derivatives could be efficient in lowering psychological feelings such as extreme anger and aggressiveness in the affected people. Similarly, individuals incapable of expressing their feelings could be motivated to take depressants such as alcohol in order to reduce inhibitions and enhance expressions of their emotions (Shotton, 1991). Therefore each chemical substance, including those that people abuse are specifically designed to cure different dysphoric states and as a replacement of an underlying psychological malfunctioning. However, the trick is to take it in moderation to address the psychological impairment and avoid intoxication and subsequent dependence in the process. The third view of individual perspective to addiction is based on the social psychological theory of self-regulation. This approach attributes failure of self-regulation to the emergence of various social pathologies contributing to addiction on various activities and substances (Freimuth, 2005). Craig (1995) argues that every process in an addictive activity is accompanied by both self-regulating mechanism and pathological behaviours. Failure to balance these elements could cause conflicts and under regulation of the pathological behaviours, leading to development of addiction or dependence to the particular substance or activity. The progress or development of an activity to become an addictive habit is enhanced by patterns of behaviour that enhance the transition from the breakdown in the ability to self control leading to complete loss of self regulation that ultimately cause intense and repetitive suffering (Piazza and Le Moal 1998). Therefore, lack of self-control could enhance the development of addiction and a person’s propensity to exit or start using the drugs or engaging in other addictive activities (Brian and Peter 2005). Book (1997) attributes the lack of self-regulation to the malfunctioning of various mental processes, which involve processing of information, reasoning, self-monitoring, among others that are mainly undertaken in the frontal lobe in the brain. According to Aston- Jones and Harris (2004), the prevailing social and environmental conditions play an important role in initiating drug and process addiction while the neurobiological and neuropharmacological factors contribute to establishment of dependency or addiction. Social and environmental factors in various developmental stages have varying degrees of enhancing vulnerability to drug dependence on people of different ages. For instance exposing adolescents to illegal drugs increases their vulnerability of becoming drug addicts in adult stage. A study conducted by Craig (1995) established that individual who start using drugs at early stages of their lives have high degree of developing drug dependence. Numerous research studies have demonstrated that the process of drug addiction starts with the use of legal drugs such as alcohol, cigarettes and later the person graduates to more potent and illegal drugs. Bernes, et al (2002) noted that marijuana acts as the transition drug from the legal to more addictive substances. Comorbidity and the temperament of an individual also play an important role in influencing vulnerability to drug addiction. According to Young (1998), personality traits that increase the vulnerability to addiction includes the lack of self-control and inhibition, and propensity to seek pleasure. Chemical and process addiction is also closely associated with the presence of various mental disorders, including mood and anxiety ailments, and antisocial personalities. A study conducted by Knauer (2002) established that over 35% of drug addicts suffer from mood disorders. Another study established that the over 45% of all drug addicts are afflicted with anxiety disorders while about 50% demonstrate antisocial personality disorder (Di Clemente, 2003). The genetic constitution of an individual plays a major role in determining drug and process addiction. According to Berman and Siegel (1999), certain combination of genes determines the degree of drug metabolism in the body, which in turn affects the potency and subsequent addiction or tolerance. Equally important, genetic constitution influences the development of social and medical conditions such as mental disorders, which increase the vulnerability of the affected person to abuse drugs. Similarly, certain genetic combinations can protect an individual from drug addiction (Carnes, Murray, and Charpentier 2005). The process of Chemical addiction The process of chemical addiction takes place in different parts of the brain and it involves various and numerous neurotransmitters. Freimuth (2005) argues that the brain reward system is the most crucial segment responsible for development of drug addiction. According to Hollander and Stein (2006), the potent drugs stimulate the parts of the brain that regulate important behaviour patterns necessary for survival of the species. These behaviours include feeding, mating and social interactions. When chemical substance or drug is ingested, it stimulates production of dopamine, or inhibits the breakdown of the neurotransmitter (Piazza, and Le Moal, 1998). According to Shotton (1991) dopamine is a neurotransmitter that is concentrated in the areas of the brain responsible for regulating emotions, motivation and pleasure. The drugs stimulates over production of this particular neurotransmitter. Berman and Siegel (1999) argue that addictive drugs stimulate more production of neurotransmitter in the brain than other natural stimuli such as sex or desire to eat do. Higher dopamine production results to a greater intensity of pleasurable experience, a condition that is stored in the brain’s memory. Therefore, the brain associates the drug with producing pleasure. When the person continues taking the drug, dopamine production reduces and it falls below the threshold level. In addition, the number of dopamine receptors decreases (Bernes, et al 2002). Thus, the person does not experience pleasurable experience while using the same quantity of the drug he or she used before. Therefore, the person resorts to taking greater quantities because the body has become tolerant to the drug. Thus, long-term drug dependence leads to a decline in joy or pleasure derived from the habit causing withdrawal symptoms (Craig, 1995). Long-term addiction changes the structure of the brain and this condition makes the people vulnerable to relapsing back to the dependency after undergoing drug rehabilitation (Berman, and Siegel, 1999). Sex addiction Sex addiction is characterised by engaging in unrelenting and escalating sexual relationships, in spite of being cognizant of the serious consequences that such behaviour presents to oneself and others (Book, 1997). Book (1997) attributed the pleasant feeling emanating from neurochemical changes during sexual intercourse as the major cause of dependence. Sexual addiction remains one of the most underreported forms of dependency in the contemporary society mainly because of taboos associated with sex. Di Clemente (2003) estimated the proportion of adult sexual addicts in United States to be about 3 to 4 percent. This proportion does not represent paedophiles and other forms of sexually deviance, but mature people in heterosexual or homosexual relationships. There are various forms of sexual addiction, which include obsessive masturbation, sexual intercourse with commercial sex workers and engaging in multiple sexual relations within the confines of a monogamous committed relationship (Knauer, 2002). Sexual addiction is demonstrated in other types of behaviour including regular voyeurism and exhibitionism in addition to persistent sexual abuse of children and non-consenting adults through rape. Sexually addicted individuals possess a compulsive need to experience sexual gratification. Just like chemical addictions, sexual dependent individuals feel a sense of powerlessness in controlling the habit and are cognizant of the negative effects of the behaviour to their health and other people. Sexually addicted people persistently seek opportunities for engaging in the behaviour. Consequently they spend a great deal of time and resources in planning, participating and recovering from sexual escapades, at the expense of socialization, physical exercises and engaging productively in their careers (Knauer, 2002). In addition, Book (1997) notes that sex addicts use sexual fantasies as an approach of dealing with challenging experiences and emotions. Therefore, sexual addicts require frequent sexual encounters in order to achieve higher levels of arousal and gratification. However, pleasure derived from sexual encounters declines over time and the person experiences withdrawal symptoms characterized by changes in mood and behaviour from the norm. Thus, the sexually addicted person must consistently engage in constant sexual activity, which in most cases implies involvement with multiple partners. Many research studies on causes of sexual addiction attribute the development of the condition to social and environmental factors during critical development stages especially during adolescence and childhood. Piazza and Le Moal (1998) attributed sexual abuse of minors during their formative years to development of sex addiction. A research conducted by Carnes, Murray, and Charpentier (2005) established that about 80% of sex addicts reported experiencing sexual abuse during their childhood while 73 % reported physical abuse. Moreover, the study established that a massive 97% of addicted persons experienced emotional abuse and/or neglect during their early developmental stages (Carnes, Murray, and Charpentier 2005). Book (1997) argues that denying children parental love causes repression of emotions, which could later motivate the child to engage and become addicted to sex. Sex addiction just like substance abuse is a process, which begins with emotional pains that relates to the past traumatizing experience. When the experience is triggered by present suffering or pain, the person feels stressed and the desire to seek relief creates obsession for a sexual experience. While is such a situation, a thought of lust stimulates the compulsive desire to relief the current pain and experience a pleasant feeling (Carnes, Murray, and Charpentier, 2005). Di Clemente (2003) noted that the sexually addicted person could attempt to resist the compulsion, but the attempt is futile. Soon, the person begins conducting sexual activities that offer gratification, such as masturbation and promiscuity. However, after committing the act, the pleasant feeling disappears and feeling of guilt, shame, regret could set in. Carnes, Murray, and Charpentier (2005) note that the resulting feelings of shame and guilt are repressed creating a sense of despair or unsuccessful resolve to cease from the habit. According to Book (1997), repression and denial offers temporary reprieve and in the process, sexual addiction behaviour becomes reinforced in the body. Finally, withdrawal symptoms sets in and the person experiences stress, mood swings and other unpleasant feelings. To get relief from these distressing emotions, the person starts experiencing unexplainable compulsive need for lust and the cycle begins once again. Gambling addiction Gambling addiction is increasingly becoming a major social problem in the contemporary society and has attracted considerable research for the past few decades. The diagnostic and statistical manual of mental disorders (DSM-IV) has developed a list containing ten parameters for diagnosing gambling addiction. According to Daniels (2007), a person is a pathological gambler if his or her behaviour conforms to at least five parameters indicated in the ten list criteria. Conformity to less than three parameters in the criteria is an indicator that the person has a gambling problem (Daniels, 2007). Causes of gambling addiction are subject to debate and controversies. Nonetheless, researchers have identified several behavioural and environmental factors that increase vulnerability of an individual to gambling addiction. According to Berman and Siegel (1999), individuals with behavioural challenges such as addiction to chemical substances have higher probability of engaging in gambling compared to those without addictive problems. Secondly, personality and mood disorders increase the vulnerability of a person to gambling addiction (Berman and Siegel 1999). Other research studies on the causes of gambling attribute the problem to genetic constitution of an individual. Daniels (2007) argues that individuals born to parents with gambling problem have a higher likelihood of developing the problem. Just like substance addiction, the age at which an individual is exposed to gambling determines whether the person becomes addicted or not. Hollander and Stein (2006) noted that people exposed to gambling an early age are more likely to become addicted than those who learn late in adulthood and old age. Besides these factors, accessibility to gambling facilities influences the behaviour of people towards acquisition of the habit. Communities with accessible casinos and other gambling facilities have higher proportion of gambling addicts compared to those without (Daniels, 2007). The exact prevalence of gambling in the society remains uncertain especially in the current information and technology age where the habit is conducted online. Gambling addiction permeates across all social economic levels regardless of financial and education status or gender of an individual. However, men are more likely to become gamblers compared to women (Daniels, 2007). A research conducted by Block (2008) attributes the disparity to differences in their brains. The portion of the brain responsible for producing feelings of rewards is more vibrant in men than in women (Block, 2008. Thus, men experience a greater sense of excitement engaging in addictive habits such as gambling than women. Gambling addiction has negative economic and social effects to the society. According to Berman and Siegel (1999), gambling is a very expensive habit to maintain and causes severe financial problems to the addicted persons and their families. Numerous research studies on gambling indicate that the habit causes numerous social problems, which include break down of families through divorce and separation loss of family properties such as homes in order to sustain the habit. Gambling addiction increases crime because most addicted people resort to illegal means of acquiring money to indulge in the habit. Therefore, the family is compelled to pay for the embezzled funds and bear other financial costs associated with the habit such joblessness and loss of income. Other effects of gambling to the family include domestic violence, neglecting and abusing children, which causes profound psychological suffering to the affected members. In addition, pathological gamblers are more likely to commit suicide than non-gamblers (Brechara, 2005). Moreover, pathological gamblers have higher risks of losing their jobs because of chronic absenteeism and reduced productivity at their working stations. Daniels (2007) estimated that an average gambler loses a mean of seven working hours per month and this cost their employer about $1300 per annum. Moreover, gambling addiction exposes individuals to heavy debts. For adolescents and young adults in education institution, addiction in gambling reduces their academic achievement and performance. Moreover, students addicted to gambling are more likely to drop out of school than those who are not (Daniels, 2007). Internet addiction Internet dependency is another prevalent process addiction problem in the society. Although the internet addiction is not yet included in the DSM-IV classification of behavioural problems, it has gradually developed into a major challenge in the current society. Internet addiction disorder (IAD) is mainly characterised by obsessive computer use to a point where the usage interferes with a person’s normal life (Block, 2008). Internet addiction involves obsessions with online and offline application in the computer and other devices including mobile phones. Young (1998) classified the computer-based obsessions into three broad categories, which include addictive games, preoccupation with sexual content in the internet and finally instant messaging and emails. Internet addicts demonstrate four major behavioural symptoms. The first includes extreme use of internet and the computer application. This obsession consumes large proportion of time and consequently, internet addicts demonstrate acute lack of time management skills and loss of motivation to pursue other interests in life (Young, 1998). The second defining characteristic of internet addicts is social and emotional withdrawal. Shotton (1991) noted that the addicts demonstrate withdrawal symptoms such as stress, anger, and anxiety among others when access to the addictive computer applications is denied. The third characteristic of internet addiction is tolerance demonstrated by desire to upgrade their computers to enhance its efficiency and increase greater access to the addictive applications and willingness to spend more time on the internet at the expense of other activities (Young, 1998). The fourth and final behavioural symptom of internet addiction includes negative consequences demonstrated in poor academic performance, lack of social skills and tiredness among other effects (Young, 1998). Internet addicted people show similar characteristics to drug dependent individuals. These include resistance to rehabilitation and high relapse rate. Moreover, internet addiction is closely associated with inherent mental disorders, such as personality and mood ailments (Knauer, 2002). Research on internet addiction remains sparse, but the available findings demonstrate similar addictive process to other process addictions. Research studies indicate a positive correlation between internet use and gambling and sexual addiction. According to Cooper, et al (1999), internet addiction facilitates development of addictive behaviours including online gambling, sexual addiction and compulsive consumer behaviours such as online shopping, and stock trading. Internet use has remarkable speed and efficiency compared to other conventional methods. In addition, internet is affordable, easily accessible and offers the user much needed privacy (Greenfield, 1999). In relation to sex addiction, internet provides limitless pornographic sites and opportunities to meet intimate partners. Internet initiated sexual relationships progresses faster towards actual intimacy compared to traditional approaches. A study conducted by Cooper, et al (1999) established that 31% of people engaging in internet sexual contact eventually meet for actual sexual intercourse. The study established that sexual addicts preferred the internet because it provides intense intimacy, limitless opportunities of meeting partners across the world and does not inhibit expression, a major shortcoming of conventional relationships (Cooper, et al 1999). Internet has increased access to online gambling and betting, increasing the risks of addiction to these activities. Greenfield (1999) argues that online betting and gambling are becoming popular because of the remote nature of transactions, which makes money appear less real. In addition, the non-existent human contact in the internet undermines the ability to make reasonable judgement and take control of the gambling impulses. Relationship between chemical and sex, gambling and internet addiction Process addictions have various similarities with chemical dependency. In a study investigating similarities between gambling and substance addiction, Aston- Jones and Harris (2004) established five similarities. The first similarity is that both addictions demonstrate cognitive distortions and impairments in making decisions among the affected persons. The second similarity was that individuals addicted to gambling and drugs persistently seek to undertake the drugs or gambling activity in order to become aroused. In addition, the addictions transform the structure of their brain, which hinder successful rehabilitation because the addicted people have high chances of relapsing. The fourth similarity is that people addicted to gambling and drugs record a reduction in enjoyment derived from the respective activity as the time goes by. Finally, gambling and chemical addictions make the person lose control in managing or regulating the habit (Aston- Jones and Harris 2004: pp73-94) Research on the causes of process and chemical addictions have elicited a great deal of similarities. In relation to both types of addictions, negative reinforcement theories contend the influence that environmental and social factors have in creating stress and unpleasant feelings, which motivate people to use chemical substance or engage in process addictions in order to alleviate the tensions (Piazza, and Le Moal 1998). A number of personal and social factors increase the vulnerability of an individual to process and substance addiction. These include poor self-control, traumatising events especially during childhood and social deprivation in addition to psychiatric conditions. Poor self-control undermines the ability of people to regulate their impulses (Ladouceur, et al 2002: 109). According to Michel and Koob (2007), people with poor self-control succumb to their impulse easily, increasing their vulnerability to both process and chemical addictions. In addition, individuals who require high level of excitement have a high tendency of engaging in risky behaviours such as sex and gambling in order to enhance the degree of arousal. Conclusion Several research studies have established that traumatic events during early developmental stages increase the vulnerability of people to process and chemical addictions. According to Freimuth (2005), child negligence, traumatic events such as separation, divorce or death of a close family member in addition to physical and sexual abuse distress children for a considerable period. Consequently engaging in process and drug addictions provide relief and escape for their unpleasant experiences. Psychiatric conditions, such as mood disorders demonstrate a close relationship with chemical abuse and process addictions such as gambling and sex. Poverty and economic problems play a critical role in contributing to social problems, including substance abuse, and sexual indulgence. Knauer (2002) argues economic deprivation encourage the drug and sexual addiction in addition to gambling due to the need to augment income. Moreover, children raised in poor backgrounds are more vulnerable to parental neglect, sexual and physical abuse in addition to deprivation of necessities. These developmental challenges promote process and drug addiction as a method of coping with and escaping from the unpleasant experiences from challenging childhood. Research studies have established a relationship between substance and process addictions. A research conducted by Book (1997) established that majority of people addicted to drugs demonstrate dependency to process addictions, such as sex and gambling. Brechara (2005) noted that people addicted to chemical substances such as cocaine, heroine and methadone are four to ten times more likely to be addicted to gambling. In people addicted to both chemical and process addictions, one of the addictions could occur before the other or happen simultaneously (Brechara, 2005). In addition, several process addictions could occur simultaneously. Daniels (2007) argues that this type of cross addiction occurs when the person develops tolerance to one type of behaviour, which motivates the individual to try other types of stimulating activities to derive more pleasure. Thus, it is common phenomenon for people with addiction behaviour such as gambling to be sexually addicted as well. Therefore, Freimuth (2005) notes that process addictions accompany supplement and reinforce each other. Contemporary research is yet to establish whether one type of process addiction could lead to development of another or whether they are caused by a common factor. Bibliography APA (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR. 4th ed. Washington, DC: APA Publishing. Aston- Jones , G., and Harris, G.(2004). Brain substrate for increased drug seeking during protracted withdrawal. Neuropharmacology 47(1): pp 165-179. Berman, L., and Siegel, M.(1999). Behind the 8 ball: A guide for families of gamblers. New York: Simon and Schuster. Bernes, G., et al.(2002).Effects of alcohol misuse on gambling patterns in youth. Journal of Studies on Alcohol, 63: pp 765-780. Block, J.(2008). Issues for DSM-IV: Internet addiction. American Journal of Psychiatry. 165: pp300- 310. Brechara, A.(2005). Decision making, impulse control and loss of willpower to resist drugs: A neurocognitive perspective. Nat. Neuroscience. 8: pp 1450-1463. Brian, D., and Peter, W.(2005). Addiction to the internet and online gaming. Cyberpsychology and Behaviour. 8(2):pp 110-113. Book, P. (1997). Sex and love addiction, treatment and recovery. New York; Lucerne Publishing. Carnes, P., Murray, R., and Charpentier, I.(2005). Bargains with chaos: Sex addicts and addiction interaction disorder. Sexual Addiction and Compulsivity, 12:pp79-122. Cooper, A., et al (1999). Sexuality on the internet: From sexual exploration to pathological expression. Professional Psychology, Research and Practice. 30(2): 154-166 Craig, R.(1995). The role of personality in understanding substance abuse. Alcoholism Treatment Quarterly. 13: pp 16-27. Daniels, S.(2007). Gambling addiction: High stakes high costs and real victims. [Online]. Available from http://www.ncfpc.org/PolicyPapers/Findings%200101-Gambling%20Add.pdf [Accessed on 23 May 2012]. Di Clemente C.(2003). Addiction and change: How addictions develop and addicted people recover. New York: Guilford Press. Freimuth, M.(2005). Hidden addictions. New York: Jason Aronson. Greenfield, D.(1999). Virtual addiction: Help for netheads, cyberfreaks and those who love them. Oakland: New Harbinger Publications. Hollander, E., and Stein, D.(2006). Clinical manual of impulse control disorders: Arlington, Va: APA Publishing. Knauer, S.(2002). Recovering from sexual abuse, addictions and compulsive behaviours. New York: Haworth Press. Ladouceur, R., et al(2002). Understanding and treating the pathological gambler. New York: John Wiley and Sons Limited. Michel, M., and Koob, G.(2007). Drug addiction: Pathways to the disease and pathophysiological perspectives. European Neuropsychophamacology, 17: 377-393. Piazza, P., and Le Moal, M.(1998). The role of stress in drug administration. Trends Pharmacol. Science. 19: pp 65-75. Shotton, M.(1991). The costs and benefits of computer addiction. Behaviour Information and Technology. 10:pp 215-239. Volkow, N.(2005). What do we know about drug addiction? American Journal of Psychiatry. 162:pp 1400-10. Young, K.(1998). Caught in the net: how to recognize the signs of internet addiction and a winning strategy for recovery. New York: John Wiley and Son. Read More