A Review on Interventions for Behavioral Addictions

Öz

Addictions lead to loss of control and multiple negative consequences. Non-substance-related behavioral addictions are receiving attention as an emerging concept, and interventions for behavioral addictions are becoming widespread. This review was conducted to draw attention to the issue by addressing the effectiveness of interventions for behavioral addictions. In order to identify studies examining interventions for behavioral addictions published in Turkish or English and after 2010 in Pubmed, ScienceDirect, Turkish Psychiatry Index, and TR Index databases, the keywords “behavioral addiction”, “intervention”, and “effectiveness” were entered and scanned between September and December 2021. The bibliographies of the articles on behavioral addictions were scanned, and review and descriptive studies were excluded. As a result, 26 studies were included in the review. When the studies are examined, it is seen that pharmacological studies are not common, psychotherapeutic interventions based on cognitive-behavioral approaches are mainly studied, a group approach is adopted, interventions that deal with various life arrangements can be used, the applied interventions make a significant difference, and longterm follow-up is important. Interest in behavioral addictions may contribute to the presentation of more effective practices. The positive and negative effects of various psychiatric conditions accompanying behavioral addictions and the presence of concurrent addictions on interventions should be considered. There seems to be a need for studies testing interventions for behavioral addictions in our country.

Anahtar Kelimeler

• behavioral addiction
• effectiveness
• intervention

Davranışsal Bağımlılıklara Yönelik Müdahalelere İlişkin Bir Derleme

Öz

Bağımlılıklar, kontrol kaybına ve çoklu olumsuz sonuçlara yol açmaktadır. Madde kullanımı içermeyen bağımlılıklar ilgi görmeye başlamış ve bu tür bağımlılıkların iyileştirilmesi için sunulan müdahaleler yaygınlaşmıştır. Bu derleme, davranışsal bağımlılıklar için uygulanan müdahalelerin etkilerini ele alarak konuya dikkat çekmek amacıyla yapılmıştır. Davranışsal bağımlılıklara yönelik müdahaleleri ele alan çalışmaları belirlemek için 2021 yılı Eylül ve Aralık ayları arasında Pubmed, ScienceDirect, Türk Psikiyatri Dizini, TR Dizin veri tabanlarında 2010 yılı sonrası yayımlanmış Türkçe ve İngilizce çalışmalar “davranışsal bağımlılık”, “müdahale”, “etkililik” anahtar kelimeleri girilerek taranmıştır. Davranışsal bağımlılıklara ilişkin makalelerin kaynakçaları taranmış, derleme ve betimsel çalışmalar dışta bırakılmıştır. Tarama sonucunda 26 çalışma araştırma kapsamına alınmıştır. Ele alınan çalışmalar incelendiğinde; farmakolojik çalışmaların yaygın olmadığı, yaygınlıkla bilişsel-davranışçı yaklaşımlar temelinde psikoterapötik müdahalelerin çalışıldığı, bireysel müdahalelerdense katılımcıların grup olarak alınması yaklaşımının benimsendiği, ayrıca danışanların yaşamlarında yapılacak düzenlemelerin kullanılabildiği, uygulanan müdahalelerin bağımlılık puanlarında anlamlı bir azalma ile sonuçlandığı ve uzun süreli izlemenin önemli olduğu görülmektedir. Davranışsal bağımlılık kapsamında daha fazla araştırma yapılması daha etkili uygulamaların sunulmasına katkı sağlayabilir. Davranışsal bağımlılıklara eşlik eden çeşitli psikiyatrik durumlar ve eş zamanlı bağımlılıkların varlığının, müdahalelere olumlu ve olumsuz etkileri göz önünde tutulmalıdır. Yurt içinde davranışsal bağımlılıklara yönelik müdahalelerin etkilerini inceleyen araştırmalara gereksinim olduğu görülmektedir.

Anahtar Kelimeler

• davranışsal bağımlılık
• etkililik
• müdahale

Kaynakça

1. Abbott, M., Bellringer, M., Vandal, A. C., Hodgins, D. C., Battersby, M. ve Rodda, S. N. (2017). Effectiveness of problem gambling interventions in a service setting: A protocol for a pragmatic randomised controlled trial. BMJ Open, 7(3), 1–10. https://doi.org/10.1136/bmjopen-2016-013490
2. Afriwilda, M. T. ve Mulawarman, M. (2021). The effectiveness of motivational interviewing counseling to improve psychological well-being on students with online game addiction tendency. Islamic Guidance and Counseling Journal, 4(1), 106–115. https://doi.org/10.25217/igcj.v4i1.1235
3. Alavi, S. S., Maracy, M. R., Jannatifard, F. ve Eslami, M. (2011). The effect of psychiatric symptoms on the internet addiction disorder in Isfahan's University students. Journal of Research in Medical Sciences, 16, 793–800.
4. Alavi, S. S., Maracy, M. R., Jannatifard, F., Eslami, M. ve Haghighi, M. (2010). A survey relationship between psychiatric symptoms and internet addiction disorder in students of Isfahan universities. Scientific Journal of Hamadan University of Medical Sciences and Health Services, 17, 57–65.
5. Alegria, A., Bernardi, S. ve Blanco, C. (2010). Pathological gambling: obsessive-compulsive disorder or behavioral addiction? Revista Colombiana de Psiquiatria, 39, 133–142.
6. Amerikan Psikiyatri Birliği (2013). Ruhsal bozuklukların tanısal ve sayımsal elkitabı (5. Basım) (DSM-V) (E. Köroğlu, Çev.). Hekimler Yayın Birliği.
7. Andreassen, C. S., Griffiths, M. D., Gjertsen, S. R., Krosbakken, E., Kvam, S. ve Pallesen, S. (2013). The relationships between behavioral addictions and the five-factor model of personality. Journal of Behavioral Addictions, 2(2), 90–99. https://doi.org/10.1556/JBA.2.2013.003
8. APA. (2000). Diagnostic and statistical manual of mental disorders (DSM-IV TR). American Psychiatric Association.

9. Aydın, İ. E. (2016). Üniversite öğrencilerinin sosyal medya kullanımları üzerine bir araştırma: Anadolu Üniversitesi örneği. Selçuk Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 35, 373–386.
10. Baykan, N. (2014). Anne-baba tutumları ile internet bağımlılık düzeyi arasındaki ilişkinin incelenmesi [Yayımlanmamış Yüksek Lisans Tezi]. Yeditepe Üniversitesi.
11. Billieux, J., Schimmenti, A., Khazaal, Y., Maurage, P. ve Heeren, A. (2015). Are we overpathologizing everyday life? E tenable blueprint for behavioral addiction research. Journal of Behavioral Addictions, 4(3), 119–123. https://doi.org/10.1556/2006.4.2015.009
12. Black, D. (2013). Behavioural addictions as a way to classify behaviours. Canadian Journal of Psychiatry, 58(5), 249–251. https://doi.org/10.1177/070674371305800501
13. Chebbi, P., Koong, K. S., Liu, L. ve Rottman, R. (2000) Some observations on internet addiction disorder research. Journal of Information Systems Education, 11(3-4), 97–104.
14. Cowlishaw, S., Merkouris, S., Dowling, N., Anderson, C., Jackson, A. ve Thomas, S. (2012). Psychological therapies for pathological and problem gambling. Cochrane Database of Systematic Reviews, 11, 1465–1858. https://doi.org/10.1002/14651858.CD008937.pub2
15. Davis, R. A. (2001). A cognitive-behavioral model of pathological internet use. Computers in Human Behavior, 17(2), 187–195. https://doi.org/10.1016/S0747-5632(00)00041-8
16. Demetrovics, Z. ve Griffiths, M. D. (2012). Behavioral addictions: past, present, and future. Journal of Behavioral Addictions, 1(1), 1–2. https://doi.org/10.1556/JBA.1.2012.1.0
17. Demir, D. ve Bektaş, M. (2021). The effect of an obesity prevention program on children’s eating behaviors, food addiction, physical activity, and obesity status. Journal of Pediatric Nursing, 61, 355–363. https://doi.org/ 10.1016/j.pedn.2021.09.001
18. Demirbaş, H. (2021). Kumar bağımlılığı. Alkol dışı madde kullanımı ve bağımlılığı (Birinci Basım). Nobel Yayıncılık.
19. Dittmer, N., Voderholzer, U., Mönch, C., Cuntz, U., Jacobi, C. ve Schlegl, S. (2020) Efficacy of a specialized group intervention for compulsive exercise in patients with anorexia nervosa: A randomized controlled trial. Psychotherapy and Psychosomatics, 89, 161–173. https://doi.org/10.1159/000504583
20. Dixon, M., Wilson, A. ve Habib, R. (2016). Neurological evidence of acceptance and commitment therapy effectiveness in college-age gamblers. Journal of Contextual Behavioral Science, 5(2), 80–88. https://doi.org/10.1016/j.jcbs.2016.04.004
21. Ede, M. O., Okeke, C. I., Igbo, J. N. ve Aye, E. (2021). Testing the efficacy of group cognitive-behavioral therapy on pathological internet use among undergraduate in Nigeria. Trends in Psychiatry and Psychotherapy, 45, 1-31. https://doi.org/10.47626/2237-6089-2021-0348
22. Ede, M. O., Omeje, J. C., Ncheke, D. C., Agah, J. J., Chinweuba, N. H. ve Amoke, C. V. (2020). Assessment of the effectiveness of group cognitive behavioral therapy in reducing pathological gambling. Journal of Gambling Studies, 36(4), 1325–1339. https://doi.org/ 10.1007/s10899-020-09981-y
23. Filomensky, T. Z. ve Tavares, H. (2009). Cognitive restructuring for compulsive buying. Brazilian Journal of Psychiatry, 31(1), 77–78. https://doi.org/10.1590/S1516-44462009000100018
24. Gonzales-Bueso, V., Santamaria, J. J., Fernandez, D., Merino, L., Elena, M., Jimenez-Murcia, S., Pino-Gutirrez, A. ve Ribas, J. (2018). Internet gaming disorder in adolescents: personality, psychopathology and evaluation of a psychological intervention combined with parent psychoeducation. Frontiers in Psychology, 9, 787–792. https://doi.org/10.3389/fpsyg.2018.00787
25. Goodman, A. (1990). Addiction: definition and implications. British Journal of Addiction, 85(11), 1403-1408. https://doi.org/10.1111/j.1360-0443.1990.tb01620.x
26. Goodwin, H., Haycraft, E., Willis, A. ve Meyer, C. (2011). Compulsive exercise: the role of personality, psychological morbidity, and disordered eating. The International Journal of Eating Disorders, 44(7), 655–660. https://doi.org/10.1002/eat.20902
27. Granero, R., Fernandez-Aranda, F., Mestre-Bach, G., Steward, T., Bano, M., Aguera, Z., Aymami, N., Gomez-Pena, M., Sancho, M., Sanchez, I., Menchon, J. M., Martin-Romera, V. ve Jimenez-Murcia, S. (2017). Cognitive behavioral therapy for compulsive buying behavior: predictors of treatment outcome. European Psychiatry, 39, 57–65. https://doi.org/ 10.1016/j.eurpsy.2016.06.004
28. Grant, J. E. ve Chamberlain, S. R. (2016). Expanding the definition of addiction: DSM-5 vs ICD-11. CNS Spectrums, 21(4), 300–303. https://doi.org/10.1017/S1092852916000183
29. Grant, J. E., Potenza, M. N., Weinstein, A. ve Gorelick, D. A. (2010). Introduction to behavioral addictions. American Journal of Alcohol Abuse, 36(5), 233-241. https://doi.org/10.3109/00952990.2010.491884
30. Griffiths, M. (1996). Nicotine, tobacco and addiction. Nature, 384(6604), 18. https://doi.org/10.1038/384018a0
31. Griffiths, M. (2005). A “components” model of addiction within a biopsychosocial framework. Journal of Substance Use, 10(4), 191–197. https://doi.org/10.1080/14659890500114359
32. He, J., Pan, T., Nie, Y., Zheng, Y. ve Chen, S. (2021). Behavioral modification decreases approach bias in young adults with internet gaming disorder. Addictive Behaviors, 113, 106686. https://doi.org/10.1016/j.addbeh.2020.106686
33. Hilker, I., Sanchez, I., Steward, T., Jimenez-Murcia, S., Granero, R., Gearhardt, A. N., Rodriguez-Munoz, R. C., Dieguez, C., Crujeiraz, A. B., Tolose-Sole, I., Casanueva, F. F., Menchon, J. M. ve Fernandez-Aranda, F. (2016). Food addiction in bulimia nervosa: Clinical correlates and association with response to a brief psychoeducational intervention. European Eating Disorders Review, 24(6), 482–488. https://doi.org/ 10.1002/rev.2473
34. Holden, C. (2001). “Behavioral” addictions: Do they exist? Science, 294(5544), 980–982. https://doi.org/10.1126/science.294.5544.980
35. Işık, E. (2009). Erişkinlerde klinik psikofarmakoloji. İçinde E. Işık ve T. Uzbay (Edl.), Güncel temel ve klinik psikofarmakoloji (ss. 337–359). Golden Medya Baskı.
36. Juhyun, J. ve Kyung-Sook, B. (2021). The effect of peer relationship enhancement programs on the prevention of smartphone addiction among late school-age children in South Korea. Journal of Pediatric Nursing, 63, 127–135. https://doi.org/10.1016/j.pedn.2021.09.025
37. Kardefelt-Winther, D., Heeren, A., Schimmenti, A., Rooij, A., Maurage, P., Carras, M., Edman, J., Blaszynski, A., Khazaal, Y. ve Billieux, J. (2017). How can we conceptualize behavioral addiction without pathologizing common behaviors? Addiction, 112, 1709–1715. https://doi.org/10.1111/add.13763
38. Khazaei, F., Khazaei, O. ve Ghanbari-H, B. (2017). Positive psychology interventions for internet addiction treatment. Computers in Human Behavior, 72(C), 304–311. https://doi.org/10.1016/j.chb.2017.02.065
39. Kim, S. M., Han, D. H., Lee, Y. S. ve Renshaw, P. F. (2012). Combined cognitive behavioral therapy and bupropion for the treatment of problematic online game play in adolescents with major depressive disorder. Computers in Human Behavior, 28(5), 1954–1959.
40. Ko, C. H. ve Yen, J. Y. (2015). Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research: Excessive behaviors are not necessarily addictive behaviors. Journal of Behavioral Addiction, 4(3), 130–131. https://doi.org/10.1556/2006.4.2015.015
41. Kwon, M. S. ve Yu, J. S. (2020). Development and effect of a smartphone overdependence prevention program for university students based on self-determination theory. Journal of Korean Academy of Nursing, 50(1), 116–131. https://doi.org/10.4040/jkan.2020.50.1.116
42. Leong, S. L., Vanneste, S., Lim, J., Smith, M., Manning, P. ve Ridder, D. (2018). A randomised double-blind placebo-controlled parallel trial of closed-loop infraslow brain training in food addiction. Scientific Reports, 8(1), 1-9. https://doi.org/10.1038/s41598-018-30181-7
43. Li, W., Garnald, E. L., McGovern, P., O’Brien, J. E., Tronnier, C. ve Howard, M. O. (2017). Mindfulness-oriented recovery enhancement for internet gaming disorder in U.S. adults: a stage I randomized controlled trial. Psychology of Addictive Behaviors, 31(4), 393–402. https://doi.org/10.1037/adb0000269
44. Lindenberg, K., Halasy, K. ve Schoenmaakers, S. (2017). A randomized efficacy trial of a cognitive-behavioral group intervention to prevent internet use disorder onset in adolescents: The protect study protocol. Contemporary Clinical Trials Communications, 6, 64–71. https://doi.org/ 10.1016/j.conctc.2017.02.011
45. Longabaugh, R. ve Magill, M. (2011). Recent advances in behavioral addiction treatments: Focusing on mechanisms of change. Current Psychiatry Report, 13(5), 382–389. https://doi.org/10.1007/s11920-011-0220-4
46. Mallorqui-Bague, N., Lozano-Madrid, M., Forcano, L., Diaz-Lopez, A., Galera, A., Fernandez-Carrion, R., Granero, R., Jimenez-Murcia, S., Corella, D., Pinto, X., Cuenco-Royo, A., Bullo, M., Salas-Salvado, J., Torre, R. ve Fernandez-Aranda, F. (2021). Effects of a psychosocial intervention at one year follow-up in a predimed plus sample with obesity and metabolic syndrome. Scientific Reports, 11(1), 1–12. https://doi.org/10.1038/s41598-021-88298-1
47. Mann, K., Keifer, F., Schellekens, A. ve Dom, G. (2017). Behavioural addictions: classification and consequences. European Psychiatry, 44, 187–188. https://doi.org/10.1016/j.eurpsy.2017.04.008
48. Männikkö, N., Billieux, J. ve Kääriäinen, M. (2015). Problematic digital gaming behavior and its relation to the psychological, social and physical health of Finnish adolescents and young adults. Journal of Behavioral Addictions, 4(4), 281–288. https://doi.org/10.1556/2006.4.2015.040
49. Marks, I. (1990). Behavioral (non-chemical) addictions. British Journal of Addictions, 85(11), 1389–1394. https://doi.org/10.1111/j.1360-0443.1990.tb01618.x
50. Noble, E. P., Zhang, X., Ritchie, T., Lawford, B. R., Young, R. M. ve Sparkes, R. S. (1998). D2 dopamine receptor and GABA-A receptor beta3 subunit genes and alcoholism. Psychiatry Research, 81, 133–147. https://doi.org/10.1016/S0165-1781(98)00084-5
51. Oei, T. P. S., Raylu, N. ve Lai, W. W. (2018). Effectiveness of a self-help cognitive behavioral program for problem gamblers: A randomised controlled trial. Journal of Gambling Studies, 34(2), 581–595. https://doi.org/10.1007/s10899-017-9723-1
52. Ögel, K. (2021). Bağımlılık ve tedavisi temel kitabı. (Dördüncü Basım). IQ Kültür Sanat Yayıncılık
53. Pallesen, S., Lorvik, I. M., Bu, E. H. ve Molde, H. (2015). An exploratory study investigating the effects of a treatment manual for video game addiction. Psychological Reports, 117(2), 490–495. https://doi.org/10.2466/02.PR0.117c14z9
54. Park, J. H., Lee, Y. S., Sohn, J. H. ve Han, D. H. (2016). Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder. Human Psychopharmacology: Clinical and Experimental, 31(6), 427–432. https://doi.org/10.1002/hup.2559
55. Perales, J. C., King, D. L., Navas, J. F., Schimmenti, A., Sescousse, G., Starcevic, V., Holst, R. J. ve Billieux, J. (2020). Learning to lose control: a process-based account of behavioral addiction. Neuroscience & Biobehavioral Reviews, 108, 771–780. https://doi.org/10.1016/j.neubiorev.2019.12.025
56. Petry, N. M., Blanco, C., Auriacombe, M., Borges, G., Bucholz, K., Crowley, T. J., Grant, B. F., Hasin, D. S. ve O’Brien, C. (2014). An overview of and rationale for changes proposed for pathological gambling in DSM-5. Journal of Gambling Studies, 30(2), 493–502. https://doi.org/10.1007/s10899-013-9370-0
57. Potenza, M. N. (2006). Should addictive disorders include non-substance-related conditions? Addiction, 101(1), 142–151. https://doi.org/10.1111/j.1360-0443.2006.01591.x
58. Potenza, M. N. (2014). Non-substance addictive behaviors in the context of DSM-5. Addictive Behaviors, 39(1), 1–4. https://doi.org/10.1016/j.addbeh.2013.09.004
59. Quinones, C. ve Griffiths, M. D. (2019). Reducing compulsive internet use and anxiety symptoms via two brief interventions: a comparison between mindfulness and gradual muscle relaxation. Journal of Behavioral Addictions, 8(3), 530–536. https://doi.org/10.1556/2006.8.2019.45
60. Robinson, T. W. ve Clark, L. (2015). Behavioral addictions. Current Opinion in Neurobiology, 30, 66–72. https://doi.org/10.1016/j.conb.2014.09.005
61. Sanal-Özcan, Y., Hamzaoğlu, N. ve Türk, B. (2020). Üniversite öğrencilerinin kimyasal ve davranışsal bağımlılıklara ilişkin bakış açıları ve bilgi düzeyleri. Bağımlılık Dergisi, 21(1), 44–55.
62. Starcevic, V. (2016). Behavioural addictions: a challenge for psychopathology and psychiatric nosology. Australian & New Zealand Journal of Psychiatry, 50(8), 721–725. https://doi.org/10.1177/0004867416654009
63. Starcevic, V. ve Khazaal, Y. (2017). Relationships between behavioural addictions and psychiatric disorders: What is known and what is yet to be learned? Frontiers in Psychiatry, 8(53), 1–5. https://doi.org/10.3389/fpsyt.2017.00053
64. Thege, B. K. (2017). The coping function of mental disorder symptoms: Is it to be considered when developing diagnostic criteria for behavioural addictions? Commentary to: How can we conceptualize behavioural addiction without pathologizing common behaviours? Addiction, 122(10), 1716–1717. https://doi.org/10.1111/add.13816
65. Thege, B. K., Colman, I., el-Guebaly, N., Hodgins, D. C., Patten, S. B., Schopflocher, D., Wolfe, J. ve Wild, T .C. (2015). Social judgments of behavioral versus substance-related addictions: a population-based study. Addictive Behaviors, 42, 24-31. https://doi.org/10.1016/j.addbeh.2014.10.025
66. Thomas, S. A., Merkouris, S. S., Browning, C. J., Radermacher, H., Feldman, S., Enticott, J. ve Jackson, A. C. (2015). The problem gambling research study (PROGRESS) research protocol: a pragmatic randomised controlled trial of psychological interventions for problem gambling. BMJ Open, 5(11), 1–16. https://doi.org/10.1136/bmjopen-2015-009385
67. Toneatto, T. (2016). Single-session interventions for problem gambling may be as effective as longer treatments. Addictive Behaviors, 52, 58–65. https://doi.org/10.1016/j.addbeh.2015.08.006
68. Uluğ, B. (2007). Alkol kullanımı ile ilişkili bozukluklar. İçinde C. Güleç ve E. Köroğlu (Edl.), Psikiyatri temel kitabı (ss. 161–172). HYB Basım Yayın.
69. Widyanto, L. L. ve Griffiths, M. (2006). ‘Internet Addiction’: a critical review. International Journal of Mental Health Addiction, 4, 31–51. https://doi.org/10.1007/s11469-006-9009-9
70. Yılmaz, A., Akaç, N., Karakaya, P. Ö. ve Sönmez, S. (2020). Sağlık bilimleri alanında öğrenim gören bireylerin bağımlılık kavramına ilişkin algıları: bir metafor analizi. Ankara Hacı Bayram Veli Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 22(2), 428–439.
71. Young, K. S. ve Rogers, R. C. (1998). The relationship between depression and internet addiction. Cyberpsychology & Behavior, 1(1), 25–28. https://doi.org/10.1089/cpb.1998.1.25