Patterns of DSM-IV Alcohol Abuse and Dependence Criteria Among Adolescents and Adults: Results From the 2001 National Household Survey on Drug Abuse

Abstract

The higher prevalence for some dependence criteria among adolescents and young adults as measured in the present study may blur the distinction between symptom reports associated with the normative development of drinking patterns and clinically relevant aspects of DSM-IV alcohol dependence.

Conceptualizing behavioural addiction in children and adolescents

“…We note that three commentators [4,6,7] disagreed with our fourth proposed exclusion criterion-behaviours better defined as a coping strategy should not be defined as behavioural addiction. We believe Thege [4] makes a strong argument when stating rhetorically that, as coping behaviours do not prevent a substance use disorder diagnosis, there is no reason why they should do otherwise for behavioural addiction.…”

“…Research on substance use disorders has shown that core features of addiction are operationalized in a way that may result in erroneous symptom assignments in adolescents [2,3]. Moreover, research on diagnostic instruments for substance use disorders has indicated age-specific symptom profiles [4]. Similar research is needed on behavioural addiction and the recent changes within the diagnostic categories for addictive disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 [5]) should not be seen as proof of validity.…”

“…We will focus upon the most essential and implementable suggestions. We were pleased to see that most of the commentators [3][4][5] were in support of our consensus development process. Their thoughts contributed to evolving the definition, which will be updated accordingly [2].…”

“…We believe Thege [4] makes a strong argument when stating rhetorically that, as coping behaviours do not prevent a substance use disorder diagnosis, there is no reason why they should do otherwise for behavioural addiction. However, we suggest keeping a modified coping exclusion criterion because, as Stein et al [8] assert, we think that an expected response to common stressors or losses should not be conceptualized as a mental disorder.…”

“…Rather, we strongly suggest [1] moving away from recycled substance addiction criteria so that we can fully embrace the unique psychological processes of potentially problematic and repeated behaviours. Tunney & James' [4] commentary supports this: 'any new recipe of behavioural addiction must include an analysis of the behaviour itself'.…”