This is a discussion of behavioural problems that may be defined as ‘process addictions’ which consist of persistent engagement with a particular behaviour despite increasing negative consequences despite the fact no mind altering substance is involved. I hope that I will show that substance/process addictions are often the result of the same psycho-social influences and can be interchangeable in a personas behavioural repertoire.

The concept of addiction, or dependence, originated in the field of substance abuse,  particularly the abuse of alcohol, opiates and cocaine Researchers have been working in this area for well over a century (e.g., Crothers, 1893) and have produced a substantial body of theoretical models and empirical data (Rosenthal, 1992; Taber et al. 1987). Substance addictions are usually thought of as a perceived loss of control caused either by the nature of the substance itself or by the psychological process the substance creates or heightens.

These concepts that have helped to define substance addiction, particularly in relation to alcoholism, have been applied to other repeated dysfunctional behaviours as opposed to substances. Therefore people may now be said to have a sex, gambling, work or other addiction. Whilst the neurological reward system more powerfully by certain substances than by behaviours it is thought that the chemical process in the brain is similar. See Childress et al. (2008) and Szalavitz (2002) for discussions of how substances can hijack such systems. Food addictions are normally classified as process addictions, even though substances are involved, this is due to the perception that food is not directly mood altering/psychotropic.

The process-addiction approach focuses more on the pathological predisposition of the client towards obsessive, compulsive, impulsive behaviours for example where as other models may be more likely to privileged other factors such as the clients, social, political, economic and cultural back ground.

It is not just the clinical world that has made the link between substance and behavioural addictions, people who identify as process addicts (gambling, food sex etc) have adopted the self help mechanisms and understanding of addictions pioneered by those suffering with substance addictions.

Addictions, substance and behaviour-based, differ from obsessions and compulsions particularly in the beginning stages as they are goal orientated and expected to have a pleasurable result where as obsessive and compulsive behaviours are rigid and expected to produce a pleasurable effect.

Negative-reinforcement theories hypothesize that a person may have a vulnerability to addiction should sufficient levels of stress or similar unpleasant feelings are produced, the person then learns that a substance or process can relieve these negative emotions.

Bio psychosocial theories posit that a combination of personal and social factors increase the likelihood of behavioural issues like problem gambling and other process addictions.Much empirical evidence to connects both substance and process addictions to pre-existing risk factors and contextual issues. Though these studies show that sometimes these external factors and the presence of addiction correlate that does not prove causality. However it is useful to address related issues even if a cause and effect relationship with the presenting issues is not proven. One issue that correlates with process addictions is a co occurring presence of a substance addiction. Those who abuse substances (particularly opiates or cocaine) are four to ten times more likely than the general population to have a gambling problem. From this we discern that addictions go together, substitute for one another and reinforce one another, this suggests that we look at addiction as a whole as opposed to focusing on each behaviour in isolation.

There is also a well documented link between social deprivation and social and economic marginalisation with a whole host of negative conditions including addictions.