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The Behavioral Addictions

Edited by Michael S. Ascher, M.D., and Petros Levounis, M.D., M.A.

  • ISBN 978-1-58562-485-0
  • Item #62485
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The Behavioral Addictions is the first American Psychiatric Publishing title to explore the diagnosis and treatment of patients who suffer from behavioral addictions, extreme forms of which share specific characteristics with severe forms of substance use disorders. These characteristics include tolerance (the need to use the substance or perform the troublesome behavior at higher doses, or more and more frequently, in order to achieve the same effect); withdrawal (feelings of restlessness, irritability, and discontent following abrupt discontinuation of the substance or the behavior); obsessive thinking and planning that block out anything other than obtaining or engaging in the addictive agent or behavior; and accompanying external consequences in related to finances, health, interpersonal relationships, legal affairs, etc. Although not all behavioral addictions are currently recognized as such by DSM-5, both substances and behaviors can hijack a person's pleasure-and-reward brain circuitry, causing great suffering.

This case-based volume is practical and engaging and offers many features that make it not only informative but also accessible and entertaining:

  • Behaviors covered, both those widely recognized and those less commonly accepted, involve exercise, food, gambling, Internet gaming, Internet surfing, kleptomania, love, sex, shopping, work, tanning, and e-mailing/texting.
  • Introductory chapters discuss the relationship of behavioral or process addictions to substance use disorders across many spheres, and they provide an overview of the behavioral addictions from neurobiological, theoretical, clinical, and forensic perspectives.
  • Gambling disorder is now classified in DSM-5 as a behavioral addiction, lending credence to the construct of behavioral addictions and providing precedent for future consideration of other behavioral addictions, such as those highlighted in the volume.
  • Each chapter focuses on a real-life case study of a patient with a behavioral addiction. Videos that accompany the volume demonstrate encounters between a clinician and a patient exhibiting an addiction. This puts material on assessment, treatment, etc. into a real-world context.
  • Key points for review and multiple-choice questions are included at the end of each chapter.

Not simply an exaggeration of everyday social and personal ailments, these behavioral conditions present clinicians with unique and poorly researched challenges in everyday clinical practice. The Behavioral Addictions helps the reader to determine not only where to draw the line between healthy and unhealthy levels of participation in a behavior, but also how to intervene in ways that are therapeutic, effective, and evidence-based.


  • Contributors
  • Preface
  • Video Guide
  • Part I: Introduction
  • Chapter 1. Helping People Behave Themselves: Identifying and Treating Behavioral Addictions
  • Chapter 2. Forensic Implications of Behavioral Addictions
  • Part II: The Behavioral Addictions
  • Chapter 3. Problematic Exercise: A Case of Alien Feet
  • Chapter 4. Food Addiction: Sugar High
  • Chapter 5. Gambling Disorder
  • Chapter 6. Internet Gaming Disorder: Virtual or Real?
  • Chapter 7. Internet Addiction: The Case of Henry, the Reluctant Hermit
  • Chapter 8. Texting and E-mail Problem Use
  • Chapter 9. Kleptomania: To Steal or Not to Steal—That Is the Question
  • Chapter 10. Sex Addiction: The Fire Down Below
  • Chapter 11. Love Addiction: What's Love Got to Do With It?
  • Chapter 12. Shopping Addiction: If the Shoe Fits, Buy It in Every Color!
  • Chapter 13. Tanning Addiction: When Orange Is the New Bronze
  • Chapter 14. Work Addiction: Taking Care of Business
  • Index


    Michael S. Ascher, M.D.
    Jonathan Avery, M.D.
    Timothy K. Brennan, M.D.
    Alexis Briggie, Ph.D.
    Clifford Briggie, Psy.D., LADC, LCSW
    Lisa J. Cohen, Ph.D.
    Elias Dakwar, M.D.
    Emily Deringer, M.D.
    Eric Y. Drogin, J.D., Ph.D., ABPP
    Jessica A. Gold, M.D., M.S.
    Mark S. Gold, M.D.
    Nicole Guanci, M.D.
    Yu-Heng Guo, M.D.
    Samson Gurmu, M.D.
    Carolyn J. Heckman, Ph.D.
    Yael Holoshitz, M.D.
    Najeeb Hussain, M.D.
    Daniel Lache, M.D.
    Petros Levounis, M.D., M.A.
    Sean X. Luo, M.D., Ph.D.
    Omar Mohamed, B.A.
    Sabina Mushtaq, M.D.
    Dmitry Ostrovsky, B.A.
    Nancy M. Petry, Ph.D.
    Marc N. Potenza, M.D., Ph.D.
    Carla J. Rash, Ph.D.
    Mahreen Raza, M.D.
    Robert L. Sadoff, M.D.
    Tolga Taneli, M.D.
    Kimberly A. Teitelbaum, ARNP
    Justine Wittenauer, M.D.
    Tauheed Zaman, M.D.
    Erin Zerbo, M.D.

About the Authors

Michael S. Ascher, M.D., is a Clinical Associate in Psychiatry at the University of Pennsylvania, Perelman School of Medicine in Philadelphia, Pennsylvania.

Petros Levounis, M.D., M.A., is Chair of the Department of Psychiatry at Rutgers New Jersey Medical School and Chief of Service at University Hospital in Newark, New Jersey.

Empirical studies often lag behind clinical knowledge, particularly in an emerging area like behavioral addictions. Drs. Ascher and Levounis have done a remarkable job in combining both research to date and experts' practical experience on this issue. What emerges from this is an excellent text for all clinicians.—Marc Galanter, M.D., Professor of Psychiatry, and Director, Division of Alcoholism and Drug Abuse, NYU School of Medicine

This casebook is Petros Levounis' second publication covering the topic of Addiction through case vignettes. With lead author, Michael Ascher, they compile a panoply of a dozen real life clinical cases with catchy titles, thoughtful introductions and enticing histories with ample space for the patient's own discourse. The conclusions summarize the available treatment options. The vignettes are preceded by a couple of introductory chapters reviewing relevant diagnostic and forensic implications. The knowledge acquired in each chapter is then anchored through a listing of key points, multiple choice questions and an accompanying DVD. This is a state-of-the-art educational offering that is clinically relevant, easy to read and fun!—Nady el-Guebaly, M.D., Professor & Head, Addiction Division, University of Calgary, Canada, Research Director, Alberta Gambling Research Institute

Behavioral addictions are one of the most vexing problems facing psychiatry, posing questions about diagnosis and treatment; the use of the diagnoses in courts of law; and the public image of psychiatry. Ascher and Levounis have managed to pack this book with everything we know about each of these questions. At once scholarly and practical, it belongs in the library of every clinician seeing patients with these sometimes devastating disorders.—Nada Stotland, M.D., M.P.H., Professor of Psychiatry, Rush University

Kudos to Ascher and Levounis for recognizing that addiction is a disease defined symptomatically by the discomfort experienced by an individual in the absence of a particular substrate, and for further recognizing that the substrate may be more than simply a substance that can produce physiologic dependence. The substrate can include emotional states, activities, and pastimes. The addict, to enter recovery, must remain abstinent not merely from dependence-inducing substances, but from all activities which, for that individual, generate a response that ultimately stifles interpersonal relating and intimacy. The editors and their chapter authors recognize this and have taken on the topic in a compelling and constructive manner that will assist the field in moving forward.—Stuart Gitlow, M.D., M.P.H., M.B.A., President, American Society of Addiction Medicine

This book raises awareness and fosters understanding of the clinical presentations and approaches to treatment of a new frontier of non-substance addictions, many of which have been engendered by the proliferation and popularization of new technologies. It is a must-have resource for psychiatrists and other behavioral health practitioners.—Annelle B. Primm, M.D., M.P.H., Deputy Medical Director, American Psychiatric Association

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