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Article outline: Addictive Personality Brief description Description Critiques from field Support from field Common Traits Causes Biological Psychological Social What it looks like – interrelation of addictions Examples of addictions Treatment Behavioral therapy Psychotherapy Self-soothe Medication

Potential sources: - http://www.nytimes.com/1983/01/18/science/the-addictive-personality-common-traits-are-found.html?pagewanted=all - http://serendip.brynmawr.edu/bb/neuro/neuro04/web1/mcurtiss.html - http://www.umassmed.edu/news/2012/community/adolescent-psychiatrist-talks-about-addictive-personalities.aspx - http://www.erikbohlin.net/Handouts/personality_traits_of_addiction.htm - http://www.ncbi.nlm.nih.gov/pubmed/22177401 - http://www.ncbi.nlm.nih.gov/pubmed/22398819 - http://www.ncbi.nlm.nih.gov/pubmed/9775962 - http://www.ncbi.nlm.nih.gov/pubmed/14733449 - http://www.ncbi.nlm.nih.gov/pubmed/22882397 - http://www.ncbi.nlm.nih.gov/pubmed/7960304 - http://www.ncbi.nlm.nih.gov/pubmed/10957796 - http://www.ncbi.nlm.nih.gov/pubmed/11505909 - http://www.ncbi.nlm.nih.gov/pubmed/3437410 http://www.livestrong.com/article/19257-addictive-personality-disorder-symptoms/ http://www.livestrong.com/article/13068-spot-addictive-personality/ http://www.livestrong.com/article/103709-addictive-personality-characteristics/ http://www.healthguidance.org/entry/15805/1/Addictive-Personality-Disorder.html

Addictive Personalities Critiques of current article: Article neglects to mention: -	addictive personality as a disorder is much debated topic o	many believe it lacks enough scientific research to be considered a theory o	others believe that there are definite similarities in personality traits across different types of addicted people -	a clear definition of common traits among these people that make them more susceptible to addictions o	Impulsive o	“No delayed gratification” o	Depression o	Antisocial traits o	Stress-management -	Biopsychosocial causes of the traits o	Brain development – dopamine levels in brain, seeking reward o	Social development – desire to be rebellious, reasons why a person could have developed this affinity towards rebellion (Freud, Erikson, childhood theories) Article puts too much emphasis on: -	Types of addictions, but places too little focus on why/how these addictions form o	Neglects to describe how each of these addictions relates to the next as this personality spans across desires -	Treatment o	More should be focused on psychotherapy and behavioral therapy

To- do list: - combine description with signs & symptoms section to make definition of the personality more clear - make specific traits defined - add external links and references of our own and where marked as needed in the existing article - remove references to original research or claims that have no real basis/evidence - look at possibility of addictive personality through different theories - link out to related articles (potentially sensation seeking, internal arousal, behavioral theory, psychodynamics, etc) - section about what addictive personality may be related to (eating disorders, gambling, drugs, other behaviors) and what that connection might actually look like - expand treatment section - distinguish what “addictive personality” from being at risk for an addiction or having a predisposition for a certain behavior/disorder - tests of addictive personality (such as MacAndrew Alcoholism Scale) and their reliability/ validity

Brief Description An addictive personality is a term used to describe a personality type that has a “pre-disposition towards addictive substances (29).” Therefore, people with these personality characteristics have a higher likelihood of becoming psychologically or physically addicted to substances, items, behaviors (21). Scientists believe that there are common elements among people with varying addictions that relates to personality traits (25). Scientists such as Dr. Hatterer believe that addictive behaviors are defined by the “excessive, repetitive use of pleasurable activities to cope with unmanageable internal conflict, pressure, and stress (25).”

Symptoms A person spends excessive time on a behavior or with an item, not as a hobby but because they feel like they have to (23). Addiction can be defined when the engagement in the activity or experience affects the person’s quality of life in some way. In this way, many people who maintain an addictive personality isolate themselves from social situations in order to mask their addiction (21). People who experience addictive personality disorders typically act on impulses and cannot deal with delayed gratification (21). At the same time, people with this type of personality tend to believe that they do not fit into societal norms and therefore, acting on impulses, deviate from conformity as a rebellious act (23). Addictive personalities also make it difficult for individuals to deal with stress (21). The combination of impulsiveness and low tolerance for stress causes these individuals to have frequent mood swings and oftentimes suffer from some sort of depression (21). A coping mechanism to deal with the conflicting personality becomes their addiction and the addiction acts as something that the person can control when they find it difficult to control their personality traits (21). People with addictive personalities typically switch from one addiction to the next (22).

What is Addiction Addiction is defined by scholars as “a reliance on a substance or behavior that the individual has little power to resist (26).” Substance-based addictions are those based upon the release of dopamine in the brain, upon which the range of sensations produced by the euphoric event in the brain changes the brain’s immediate behavior causing more susceptibility for future addictions (26). Behavior-based addictions, on the other hand, are those that are not linked to neurological behavior as much and are thus thought to be linked to personality traits; it is this type of addiction that combines a behavior with a mental state and the repeated routine is therefore associated with the mental state (26).

Is there such thing as an addictive personality? There are two sides of the argument, each with many levels and variations, surrounding the debate: does an addictive personality exist? One side believes that there are certain traits and dimensions of personality that, if exist in a person, causes the person to be more prone to developing addictions throughout their life. The other side argues that addiction is in chemistry, as in how the brain’s synapses respond to neurotransmitters and is therefore not affected by personality. A major argument in favor of defining and labeling an addictive personality has to do with the human ability to make decisions and the notion of free will (29). This argument suggests human beings are aware of their actions and the consequences of their own actions are and many choose against certain things because of this. This can be seen in that people are not forced to drink excessively or smoke everyday, but it is within the reach of their own free will that some may choose to do so (29). Therefore, those with addictive personalities are high in neuroticism and therefore choose to engage in riskier behaviors. The theory of addictive personalities agrees that there are two types of people: risk-takers and risk-averse. Risk-takers enjoy challenges, new experiences and want instant gratification. These people enjoy the excitement of danger and trying new things (29). On the other hand, risk-averse are those who are by nature cautious in what they do and the activities they involve themselves in (29). It is the personality traits of individuals that combine to create either a risk-taker or risk-averse person.

Some people believe that claiming that there is such thing as an addictive personality belittles the types and significance of many tough addictions. Others also argue that by placing a label on the type of people that have addictions, this stereotypes people and denies that addiction can happen to anyone (28). Some people who agree with this argument believe that claiming an addictive personality may be used as an excuse by some who do not use drugs, and are hence not addicted, to explain why they are not addicted to drugs and other people are (28). Other arguments against this theory of addictive personalities is that it is very deterministic. By labeling someone with an addictive personality, one may think that there is no way to change the outcome and that he or she will inevitably develop addictions (27). Also, this label may cause many to believe that there is no way to change this or treat addictions, which, according to Dr. Fortuna, is untrue (27).

Biopsychosocial perspective While there is debate over whether this is one “addictive personality,” there seem to be people who are particularly vulnerable to develop an addiction to certain substances of behaviors. The causes of this addiction proneness, or addictive personality, can be examined through a biopsychosocial perspective.

Biological factors The Minnesota Twin Studies (Loewen) showed high rates of heritability both of developing the same addiction, such as alcoholism (around 50-70%), or different addictions. For example, if one twin is addicted to cocaine, the other twin has an increased likelihood of being addicted to an opiate (CNN article). Neurotransmitters are another factor thought to contribute to addictive personalities. Abnormalities in dopamine levels can lead individuals to partake in activities that give them a dopamine “high,” which then becomes addicting (Loewen). There is also evidence for the involvement of serotonin and norepinephrine in addictive proneness. Sensation seeking has been studied as having a strong relationship with addictive personalities (http://www.ncbi.nlm.nih.gov/pubmed/10668599). This sensation seeking trait may be a result an overactive “approach” system, and those individuals thus seek out external stimuli to compensate for a decreased level of internal arousal. Those who are high in sensation seeking, who have an active behavioral approach system, are more likely to develop addictions (http://www.ncbi.nlm.nih.gov/pubmed/10668599; http:// www.sciencedirect.com/science/article/pii/S0306460305001243; http:// www.sciencedirect.com/science/article/pii/S0191886901000307).

Psychosocial Alan R Lang has done much research on personality traits that play into addiction. While his research found that there is no single set of traits that is definitive of an “addictive personality,” he did find a several “significant personality factors” (NYT). These main factors are: - impulsivity - value on nonconformity combined with weak commitment to socially valued goals for achievement - sense of social alienation and tolerance for deviance - heightened stress and lack of coping skills Some advocate for the existence of an “addictive belief system” that leads people towards being more likely to develop an addiction (Washton & Boundy). This system is rooted in cognitive distortions like “I cannot make an impact on my world” and other maladaptive attitudes like “I am not good enough.” These core beliefs, often very black- and-white, set up the person to develop the many traits common in the addictive personality, such as depression and insecurity.

Social Although genes play a role in developing addictions, it is important to point out that environment pulls the trigger (CNN). Concurrent with the widely accepted diathesis- stress model, if an individual has a predisposition towards developing addictions, this alone will not cause problems. It is encountering a stress in the environment that causes the addiction to manifest. Experience with trauma appears to make someone more prone to addictions, especially “severe childhood stress” (TheFix). Examples such as physical or sexual abuse, and unpredictable expectations and behavior of parents make an individual more at risk for developing an addiction (NYT).

In looking at these traits separately, it is also necessary to look at them all together. Likewise, there is a gene/environment connection in that individuals self-select into different environments (NIAAA). This selection is based partially on personality traits, and the selected environments may or may not include increased risk for addictive behaviors. An individual might seek out environments where addictive substances are more readily available, which can also explain how addictions in these people can cross from one to another (NYT)

Common forms of addictive behavior Substance addiction One form of addiction is substance addiction. This is different from substance abuse in that abuse of a substance is not really definable while substance addiction is a behavioral addiction where there is an overwhelming involvement with the use and buying of drugs or alcohol.[7] It is a mental dependence or addiction to a substance but not a physical addiction although it can lead to a physical addiction in the end.[7]

Gambling Another common addiction that may attract those with addictive personalities is gambling. When an addict behaves mindlessly and irresponsibly while gambling, it can grow to be a bigger problem. A gambler with an addictive personality goes through three stages.[8] The first is the "winning phase" in which the person can still control his or her own behavior. Second comes the "losing phase" where the individual starts to gamble alone, borrowing cash and gambling large sums of money compiling debt which he or she may not be able to pay off. Finally, the "desperation phase" of the addictive behavior gambler is when the person takes further risks, may engage in illegal loans and activities and even experience depression or attempt suicide.[8]

Eating disorders Addictive personality behaviors even include eating disorders, such as anorexia, bulimia and compulsive overeating.[8] There are many external factors that also contribute to disordered eating behavior, but for some it can develop into a pathology quite similar to addiction. Those with anorexia nervosa channel their success into this one goal: losing weight. Once a person starts dieting, it is very difficult for him or her to quit. This is similarly true for those suffering from bulimia. A person is said to have bulimia when he or she binges on large amounts of food and then prevents digestion by purging (laxatives, vomiting, water pills, etc.).[8] With compulsive eating, the person has a compulsive urge or craving to eat and will eat even when not hungry. This addictive behavior often results in obesity.[8]

Compulsive buying Another form of addictive personality is compulsive buying disorder. Compulsive buying is different from regular consumers and different from hoarding because it is about the process of buying.[9] It is not about the items bought. In fact, these items are usually never used and are just put away.[9] They are only bought purely for the sake of buying. People who are addicted to buying describe it as a high or say that it gives them a buzz.[9] Often, when someone suffering from this is depressed, they will go out and buy items to make themselves feel better. However, compulsive buying has negative effects which include financial debt, psychological issues, and interpersonal and marital conflict.[9] To those who suffer from compulsive buying, to them, the act is the same as using a drug.[9]

People who suffer from compulsive buying usually suffer from another disorder. One study found that 20% of compulsive buyers also suffer from an eating disorder.[10] Other disorders that go hand in hand include mood disorders, depression, and anxiety. Like people with other addictions, people with compulsive buying problems tend to get confused by their feelings poorly and tend to tolerate aversive psychological states (e.g., bad moods) poorly.[11] Compulsive buying may lead to these psychological problems because sufferers become dependent on the high they experience while buying.[10] Compulsive buying puts the person in a positive mood at the time. But afterwards, the person feels intense guilt and anxiety of their purchases.[10] Treatment for compulsive buying, at this point in time, only includes cognitive behavioral therapy.[9] One way to prevent compulsive buying is education. One study found that adolescents who have taken a class or course about financial education and planning were less likely to impulsively buy products.[10]

Cell phone use Another form of addictive personality is problematic cell phone use. A recent study indicates that people who are addicted to their cell phones share common traits with those who suffer from an addictive personality.[4] Characteristics such as self-monitoring, low self-esteem, and peer approval-motivation are commonly found in those who are addicted to their cell phones as well as those who suffer from any other addiction such as alcoholism.[4] Despite personality characteristics leading to addictive tendencies, cell phones themselves can partly be blamed for causing addiction. Improvements in cell phones such as GPS, music players, cameras, web browsing, and e-mail can make them an indispensable instrument to an individual.[4] Technological advancements reinforce the over-attachment people have to their cell phones, thus contributing to addictive personality.[4]

Internet and computer use A more recent addiction that is being looked into is internet addiction. This addiction has become more prevalent in younger generations as computer technologies are advancing.[12] Internet addiction is also known as pathological Internet use.[13] When people suffer from internet addiction they find they have an inability to control their use of the Internet. This can lead to psychological, social, school and/or work difficulties for the addict.[13] Those addicted to the internet may be drawn to social networking sites, online games or other sites online. Symptoms of this addiction have been described as the following: mood changes, excessive time spent online, perceived social control while online, withdrawal when away from the computer, and perceived social benefits while online as well as other internet related signs.[13]

Tanning Another form of behavior that is still being investigated is obsessive sun tanning as a behavioral addiction. In a recent study, researchers have proved that many frequent tanners demonstrate signs and symptoms adapted from substance abuse or dependence criteria.[14] Many people who admit to being frequent tanners say they tan to look good, feel good, and to relax.[14] People who partake in excessive tanning are usually completely aware of the health risks associated with it, just like addicted smokers are completely aware of the health risks of smoking.[15] The health hazards are even more severe for high-risk age groups such as teenagers and young adults.[15] Due to the fact that the health risks do not deter tanners from their habit, they are exhibiting self-destructive behavior that resembles the characteristics of those who suffer from substance abuse.[14]

Frequent tanners have said a primary reason why they participate in artificial tanning is to experience the "feel good" feeling tanning salons have to offer.[14] Researchers have found that ultraviolet (UV) radiation from tanning beds offers mood-enhancing effects that act as a treatment for seasonal affective disorder (SAD).[14] SAD is when a person exhibits minor depression during seasonal changes, such as during the winter months.[14] Ultraviolet radiation has been proven to increase the level of melatonin in the body. Melatonin plays a key role in sleep patterns and is suggested to reduce anxiety levels.[14] Thus, those who go tanning experience a sense of relaxation afterwards. This sensation is what possibly drives tanners to continue tanning regardless of the health risks. More research needs to be done, but many researchers are beginning to add tanning to the list of addictive processes.[14]

Exercise Exercise provides benefits for our bodies, but to some people, the benefits turn into health hazards. To some exercisers, rigorous physical activity becomes the central aspect of their lives. When a preoccupation with exercise has become routine, a person is considered addicted to exercise or exercise dependent.[16] A study[by whom?] done shows why people may become addicted to exercise, especially running. One of the reasons people become addicted to exercise is because of the release of mood-enhancing chemicals known as endorphins.[16] Endorphins increase the sensation of pleasure, which is why people feel good about themselves after they exercise. Endorphins are also responsible for the "runner's high."[16] Those who suffer from exercise addiction will go through physical and emotional withdrawals in the absence of exercise, just like a person who is addicted to other substances, such as drugs or alcohol.[16] Although in many cases, running is a better alternative than substance abuse. The findings in this study conclude that there is a link between negative addiction to running and interpersonal difficulties, which is common in other addictive behaviors as well.[16]

Neurotic addictions When a person is a "normal neurotic," it is considered to be different from a personality addiction because they have fewer adversities and their addictions stem from different causes.[5] Their addiction is based off their belief system that they must perform well, live a comfortable life, and be loved. They feel they need a substance to give them relieve or distract them from their pain.[5] They are almost childlike in their demands for a substance and when their demands lead to disturbances the neurotic will insist they are not disturbed. Normal neurotics are less likely to become addicts than people with a personality disorder and have an easier time getting over their addiction.[5]

Treatment

When treating addictive personalities, the initial or presenting addiction needs to be treated first. Only once the behavior is under control can the person truly begin to do any of the therapeutic work.

One form of treatment for addictive personality is cognitive behavioral therapy and other behavioral approaches. These treatments help patients by utilizing coping skills training, relapse prevention, behavior interventions, family and group treatments, facilitated self-change approaches, and aversion therapy.[18] Behavior approaches include using positive reinforcement and behavioral modeling.[18] Along with these, other options that help with treating those who suffer with addictive personality include social support, help with goal direction, and enhancing self- efficacy.[18]

Another form of treatment, which can be overlooked, is self-soothing. People with addictive personality disorders use their addictions as a coping mechanism in stressful situations. Self-soothing and other mindfulness based interventions can be used to treat addictive personalities by providing a healthier coping mechanism when the addiction has been removed. (Skanavi, Laqueille, Aubin). These strategies relate to the use of dialectical behavior therapy, another useful technique. DBT provides ways to tolerate distress and regulate emotions, both of which are challenging to someone with an addictive personality (Downs). DBT may not be the most effective treatment for all substance abusers, there is evidence that it’s helpful for most alcoholics and addicts (Downs), as well as in eating disorders (Sipos), and those with co-occurring conditions (Downs).

Another form of treatment that has been considered for people with addictive personalities who tend towards substance abuse is medication. A medication called Disulfiram was created in 1947.[20] This pill was used for alcoholics and would cause adverse effects if combined with alcohol. This medication is still used today but two others have been made to help treat alcohol dependence (Acamprosate and Naltrexone).[20] Along with alcohol addictions, Naltrexone is also used for opioid addiction.[20] Although these medications have proven results in decreasing heavy drinking, doctors still have to consider the risky side effects when prescribing these medications.

21.	Loewen, S. C. (2012). Mental health. In Addictive personality disorder (conditions / disabilities). Retrieved November 10, 2012, from HealthGuidance website: http://www.healthguidance.org/entry/15805/1/Addictive-Personality-Disorder.html 22.	Stannard, L. (2011, March 9). Addictive personalities. In Addictive personality disorder symptoms (diseases & health conditions: addiction & recovery). Retrieved November 10, 2012, from Livestrong.com website: http://www.livestrong.com/article/19257-addictive-personality-disorder-symptoms/ 23.	Vaux, R. (2009, November 18). Addictive Personalities. In 3 ways to spot an addictive personality (diseases & health conditions: addiction & recovery). Retrieved November 12, 2012, from Livestrong.com website: http://www.livestrong.com/article/13068-spot-addictive-personality/ 24.	Nelson, B. (1983, January 18). The addictive personality: common traits are found. The New York Times. Retrieved from http://www.nytimes.com/1983/01/18/science/the-addictive-personality-common-traits-are-found.html?pagewanted=all 25.	Curtiss, M. (2004). Brain dependence: the debate over the addictive personality and gender implications. Retrieved November 10, 2012, from Serendip website: http://serendip.brynmawr.edu/bb/neuro/neuro04/web1/mcurtiss.html 26.	Nealon, D. (2012, October 3). Home. In Adolescent psychiatrist talks about addictive personalities. Retrieved November 10, 2012, from University of Massachusetts Medical School website: http://www.umassmed.edu/news/2012/community/adolescent-psychiatrist-talks-about-addictive-personalities.aspx 27.	Tangen, K., Dr. (2008, January 22). There's no such thing as an addictive personality [Web log post]. Retrieved from PsychNut personality: http://psychnut.com/personality/addictive-personalit/ 28.	Medic. (n.d.). The addictive personality - drug addiction. Retrieved November 10, 2012, from Medic website: http://www.medic8.com/drug-addiction/addictive-personality.html 29.	Kane, S. (2011, August 10). Healing the addictive personality by Dr. Lee Jampolsky [Book review]. Retrieved November 10, 2012, from Addiction Treatment Magazine website: http://www.addictiontreatmentmagazine.com/addiction-book-reviews/book-review-healing-the-addictive-personality-by-dr-lee-jampolsky/

NIAAA study: http://www.niaaa.nih.gov/about-niaaa/our-work/advisory-council/agenda- minutes/advisory-council-meeting-minutes/national-11

Loewen: http://www.healthguidance.org/entry/15805/1/Addictive-Personality- Disorder.html

CNN: http://money.cnn.com/2009/10/16/news/genes_addiction.fortune/index.htm

NYT: http://www.nytimes.com/1983/01/18/science/the-addictive-personality-common- traits-are-found.html?pagewanted=all

Washton & Boundy: http://www.recoveryoptions.us/wp-content/uploads/2010/10/ The_Addictive_Personality.pdf

The Fix: http://www.thefix.com/content/trauma-and-addiction9180

http://www.ncbi.nlm.nih.gov/pubmed/10668599

Skanavi: http://www.ncbi.nlm.nih.gov/pubmed/22032281

Downs: http://www.recoveryview.com/2010/09/dialectical-behavior-therapy-dbt-and- substance-abuse-treatment/

Sipos: http://www.ncbi.nlm.nih.gov/pubmed/21337287

Brooke and Rachel, great job on the article!

3 Strengths: -You guys really describe what an “addictive personality” is; the symptoms section is full of examples -You guys make a lot of connections to things we’ve discussed in class so it was very easy to read and follow your article - The link between addictive personalities and the biopsychosocial perspective is really developed and adds a lot of substance and information to your topic that makes it really interesting.

3 Areas for Improvement: -In the “Is there such a thing as an addictive personality?” section, you could maybe talk about addiction in relation to internal/external locus of control and field dependence/independence. It seems like that might fit in with the ideas of free will and whether or not an addicted person will make the effort to beat their addiction. - You guys mention who Dr. Fortuna is as in the article as evidence for your ideas. Personally, I do not know who she is so maybe give a sentence of background information so people know she is a reliable source. - It might be beneficial to add a real life example of someone with an addictive personality so that people can more easily understand the concept. Bansalk (talk) 18:09, 19 November 2012 (UTC) KB