When its fifth edition debuted in 2013, the authoritative Diagnostic and Statistical Manual of Mental Disorders (DSM-V) officially added a process addiction category. A motivating factor for inclusion was the similarity in neurobiological, motivational and reward-system changes involved in both process and substance addictions. Pathological gambling landed the first entry, and DSM-V identified Internet addiction as a candidate needing additional study.
Other widely regarded process additions like eating, stealing, hoarding, shopping and self-harm remained in other categories, though the American Journal of Drug and Alcohol Abuse noted in 2010 that labeling such behaviors as other disorders does not mean the classifications are mutually exclusive. While digital media can be used to research treatment options, it can also be a harmful tool that enables and promotes process addictions.
In past generations, people often had to travel somewhere to engage in their addictions and encountered fewer cues that might stimulate reward-related memories. Today, digital media like cell phones and Internet sites provide more instant access and gratification, and they facilitate dysfunctional behavior in various ways, including the following:
- Pathological gamblers have nearly unlimited access to gaming sites and casinos
- Online merchants provide constant marketplace access for shopping addicts
- Utilizing online digital media is the dysfunctional behavior itself for Internet addicts
- Extensive online restaurant marketing can trigger food cravings in an eating addict
- Forums, editorials and advertisements often discuss and encourage such behaviors
- Friends and associates on social media often glorify engagement in such processes
- Online groups exist for the very purpose of obsessing about these types of activities
A 2012 European Psychiatry journal study found that high school students with Internet addiction had higher rates of impulsivity, depression and attention deficit hyperactivity disorder (ADHD). This study and others suggest that process addicts are often also at risk for substance abuse and mental health disorders. Moreover, genetic predisposition is a major risk factor for all of these conditions, and environmental influences can play a significant role in exploiting these genetic vulnerabilities.
Trauma, especially when untreated, is one such risk factor, and it can influence addiction in the following ways:
- Trauma often leads to social withdrawal and trouble connecting with people emotionally
- Digital media provides an outlet for traumatized people wanting to avoid social situations
- Engagement in the process addiction provides psychological reward and relief
- Social media provides a way to feign social relationships while remaining isolated
Whether initiated by trauma, mental health disorders or other influences, a process addiction is dangerous and unhealthy for several reasons, including the following:
- Certain addictions like shopping and gambling can have profound financial ramifications
- Internet addiction often involves isolation that can perpetuate trauma and other disorders
- The neurological reward associated with the process begins to dominate the psyche
- Hunger for the reward leads to obsessive thoughts that bring more pain than pleasure
The access that digital media provides to such processes can result in less human contact, and loved ones are often unaware of the addiction or the extent to which it has caused damage. Whether motivated by self-awareness of the problem or an intervention, seeking professional treatment offers process addicts the best chance of recovery.
Addiction professionals craft personalized plans for each patient that potentially include behavioral therapies, trauma counseling, improved coping skills, stress management, relapse-prevention strategies and integrated care for co-occurring mental health and personality disorders.