“Addiction Chronicity: Are All Addictions the Same?”, 2022-02-08 (; similar):
Background: All addictions have a recurring nature, but their comparative chronicity has never been directly investigated. The purpose of this study is to undertake this investigation.
Method: A secondary analysis was conducted on 2 large scale 5-year Canadian adult cohort studies. A subset of 1,088 individuals were assessed as having either substance use disorder, gambling disorder, excessive behaviors (eg. shopping, sex/pornography), or 2 or more of these designations (‘multiple addictions’) during the course of these studies. Within each dataset comparisons were made between these 4 groups concerning the number of waves they had their condition; likelihood of having their condition in 2 or more consecutive waves; and likelihood of relapse following remission.
Results: Multiple addictions had statistically-significantly greater chronicity on all measures compared to single addictions. People with an excessive behavior designation had statistically-significantly lower chronicity compared to people with gambling disorder and a tendency toward lower chronicity compared to substance use disorder. Gambling disorder had equivalent chronicity to substance use disorder in one dataset but greater chronicity in the other. However, this latter difference is likely an artifact of the different time frames used.
Conclusion: Having multiple addictions represents a more pervasive condition that is persistent for most individuals. Substance use disorder and gambling disorder have intermediate and roughly equivalent levels of chronicity, but considerable individual variability, transient for some, but more chronic for others. In contrast, excessive behaviors such as compulsive shopping are transient for most, and their comparatively lower levels of chronicity questions their designations as ‘addictions’.
[Keywords: addiction, chronicity, longitudinal, cohort, gambling, substance abuse]
…Other excessive behavior tended to be more transient than gambling disorder, with 70.4% of individuals only manifesting the condition in a single time period. This is consistent with the few other studies that have examined the course of these excessive behaviors (King et al 201311ya; et al 2014). The reasons for this lower chronicity are unknown but may be related to the diversity of excessive behaviors assessed (41.0% of the sample reported shopping, 15.3% exercise; 11.1% sex or pornography, 8.3% Internet chat lines; 6.9% video or Internet gaming; 10.4% ‘other’; and 6.9% with 2 or more). It is possible there is less chronicity in certain types that decreased the overall average (this possibility is supported by the fact that gambling disorder is also a type of behavioral addiction and it is more chronic). In any case, the transient nature of these conditions raises a question about their characterization as addictions (2012; 2014). While it is clear that people can become excessively involved in these behaviors, the term ‘addiction’ implies a degree of chronicity somewhat inconsistent with the large majority of people only manifesting the problem in a single time period.