Teenage Addiction to the Internet

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Role of Behavioural Theory for Addiction Studies

“Psychology as the behaviorist views it is a purely objective experimental branch of natural science. Its theoretical goal is the prediction and control of behavior.” (Watson, 1913)

In this essay, I will briefly outline the behavioural perspective in Psychology, by reffering to key theorists who have published finding and studies on behaviourism. I will critically outline how a knowledge of behavioural techniques could be of help in a specific social care setting, nmely for people with addictions.

Behavioural Psychology or behaviourism is a theory of learning based on the idea that all behaviours are acquired through conditioning. It is focused on observable and overt behaviours that are learned from our environment. The developments of behaviourism came about by the work of Ivan Pavlov, John B. Watson, B.F. Skinner and Edward Lee Thorndike (Lumen Learning, n.d.).

Ivan Pavlov, a Russian Physiologist discovered Classical conditioning while carrying out a study on a dog’s physiological response to food. He found that the dog made an unconscious reflexive response when presented with the food, rather than response made of consciousness. He found that the salivation reflex could be elicited using a second stimulus, which in his experiment was of sound (bell). After several times ringing the bell with the presence of food, Pavlov found that ringing the bell alone triggered the salivary response. This experiment of conditioned response is considered the basic building block of learning and associative learning (Malone, 2018). In modern times, an example of this classical conditioning can be seen with the population’s addiction to smartphones. We use our smartphones as a gateway to meet our psychological, autonomy and competence needs and we have come to be in a state of continuous partial attention to them and the world around us. The sound of a smartphone ringing shows a classical conditioned response as each person reacts to the certain sound made. For example, if a smartphone rings in a crowded room and it has the same ringtone as ours, we have an unconscious response to check our phones immediately regardless of the situation in the room (Brooks, 2017) . Although this contemporary behaviour is a conditioned response, Pavlov’s work demonstatrated that what is learned can be unlearned.

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There are different types of behavioural concepts, which enable or hinder conditioned response. Firstly, Generalization, shows that response as learned will be evident in similar circumstances. Secondly, Discrimination, opposite to generalization where similar responses maybe given in some circumstances but not in different similar circumstances. The final concept, Extinction, shows that a response learned in one circumstance may not be repeated in different circumstances. Interestingly, Spontaneous recovery will show a response which was extinguished, will reappear after a prolonged period of time (Siegul, 2017).

John B. Watson was an American psychologist who furthered Pavlov’s work and focused on the theory that human behaviours cannot be studied by the analysis of the mind. He focused on the directly observable behaviour and the notion that human behaviour can be controlled. His work used animals to experiment on, as it was believed that animals exert very similar behaviours to humans. He shifted the work of psychology from the viewpoints of the mind to the facts of behaviour. The approach of observing and controlling behaviour became known as behaviourism (Watson, 1913). Establishing psychology as a scientific discipline is largely due to behaviourism objective methods and experimentation. It is used in therapies, which are popular in our society such as behavioural and cognitive behavioural therapy.

It was an American psychologist, Thorndike who came up with the theory that behaviour is predictable. He used his study on animals, like Watson, who believed that animals display similar behaviours as humans. His paper, “Animal Intelligence” announced a new law of learning. In this paper, Thorndike composed the Law of Effect which stated, “Of several responses made to the same situation, those which are accompanied or closely followed by satisfaction to the animal will, other things being equal, …will be more likely to recur; those which are accompanied or closely followed by discomfort to the animal will, other things being equal, have their connections with that situation weakened, so that, when it recurs, they will be less likely to occur. The greater the satisfaction or discomfort, the greater the strengthening or weakening of the bond”. He also established the Law of Exercise that stated, “Any response to a situation will, other things being equal, be more strongly connected with the situation in proportion to the number of times it has been connected with that situation and to the average vigor and duration of the connections” (Thorndike, 1911). The responses, which receive desired results, are more likely to be repeated.   

Skinner, like Watson was also a behaviourist who focused his studies on behaviour and the consequences of behaviour. He developed the operant conditioning chamber, or the “Skinner Box” that studied rat’s behaviours and the negative and positive results of certain behaviours. His work found that reinforcement and punishment are major factors in driving behaviour. His work of how positive and negative reinforcement of learned behaviours had a lasting impact on psychology (Lumen Learning, n.d.).  Positive and negative reinforcement is widely used in everyday life. It is evident through childhood into adulthood. In the classroom, a teacher may use rewarding system for when a child has completed their homework correctly, such as a gold star sticker. If negative behaviour is portrayed repeatedly in this setting, e.g. a student being late on a number of occasions, the student may receive lunchtime or after school detention. In the work place, employers may use financial bonuses or offer raises for excellent work performance for a continued period of time. In Ireland, there are speed limits on each road, if a person is found speeding and incurs penalty points, which rises the cost of insurance, the person, will learn to obey speed limits to not incur more significant charges. Continued positive reinforcement will motivate a person to continue to behave in the certain way while punishment inhibits the “bad behaviour”.

For the purpose of this essay, I am outlining how a knowledge of behavioural techniques could be of help to people who suffer with chemical addiction. In Ireland today, our drinking culture has brought serious problems to our health and attitude towards alcohol has had serious effect. A study done in 2017 showed thirty-nine percent of Irish adults binge drink on regular occasion compared to a worldwide average of sixteen percent (Quinlan, 2017).

Addiction is a chronic disease, which starts voluntarily for the majority of people who are drug and alcohol dependent. It is compulsive and repetitive despite knowledge that is harmful to users. It is an uncontrollable and overwhelming need to take a drug. Repeated use and abuse of certain drugs can challenge the brains ability self-control and resist urges to take drugs. These brain changes can be persistent and can cause a person who suffers with addiction to relapse even after years of abstaining from the drug (National Institute of Drug Abuse, 2018).  Serious chemical addiction is a psychological condition, which can be developed from street drugs, prescription medication and over indulgent in alcohol. The drug stimulates pleasure and motivation centres, which are normally triggered by eating, having sex, spending time with friends, in the brain more strongly than any natural rewards. Repeated drug use tricks the brain into prioritizing drugs over regular human rewards and contact. People who have addictions generally display two elements; they cannot cease or limit substance use and display an irresistible urge to continue taking and seeking the drug. This happens despite the known consequences and dangers. For example, a person who has become alcohol dependent may stop on the way home from work for one pint but will find themselves still in the pub hours later. This becomes more frequent and excessive and is unlikely to stop on its own despite the person losing his job or being caught driving under the influence. It is almost impossible for a person who is suffering from addiction to recover without medical treatment, behavioural counselling and long-term support (MacLauren, 2016).

Behavioural techniques play an important part in addiction treatment. The different types of behaviourism explained in this essay can be seen in a variety of different treatment methods. An understanding of Pavlov’s Classical Conditioning is important when supporting people who are using cue exposure therapy. The “cues” are the places or objects the person associates with their addiction as the stimuli or relapse triggers. If a person who is recovering from alcohol dependency passed their local pub each day on the way home, seeing this pub would be their relapse trigger. This is the same as the bell for Pavlov’s dog. The pub creates a powerful craving and could result in the person experiencing a relapse. A Social Care worker could encourage the person to repeatedly pass the pub. Eventually, once the person has passed the pub on a number of occasions, the pub would be disassociated with the person and they would be able to pass it without getting cravings for alcohol. The stimulus or cue would be extinguished. The learned behaviour becomes unlearned. Another example of Pavlov’s classical conditioning is in aversion therapy. This requires pairing negative behaviour with an unpleasant experience. Without this behaviour, an alcohol dependent person may associate alcohol with feelings of positivity. A drug can be administered to a person which nauseates them when the consume alcohol. After the therapy, most people will associate alcohol with nausea instead of positive feelings. This aversion therapy has been proven to wear off after a couple of months so it is important as a Social Care Worker to be able to understand and support the person and help them to enjoy their life alcohol free (Horvath, et al., 2015).

A substance can only become addictive if it is rewarding. It has to have pleasurable or enjoyable effects on the person. If a person does not enjoy their experience, they will not become addicted. Addiction is learned behaviour as the initial pleasure or enjoyment is rewarding or more worryingly immediately rewarding (Horvath, et al., 2015). Drug and alcohol abuse are learned responses that exhibit their own consequences. This is referred to as operant behaviour. The person controls the use of the drug by the unconditioned immediate positive reinforcement. Such as the psychedelic effect or the pharmaceutical effect the drug may have, controlled positive reinforcement in a social aspect such as a group of friends who also use drugs and the negative reinforcements can be seen with withdrawal affects and negative adverse events in the social setting (Queiroz, et al., 2015).  Using good health only as a reward is challenging because it has a delayed effect. Punishment or a negative is key in the early stage of addiction such as a health implication or being arrested by the Gardaí as it can stop the learned negative behaviour. Operant conditioning is effective as a treatment for the addiction. It rewards addicts for making healthier life choices (Horvath, et al., 2015). A Social Care worker can support people with addiction in a number of ways. The worker may be able to set up a rewards programme in which every number of weeks they abstain from the drug they may receive a medal or certificate. If the person relapses, the must start the programme over again. Social care workers may also be able to support family members with ideas about how to reward the person for portraying healthy behaviour and punishment for bad behaviour. This could be as simple as rewarding a teenager with a family night out bowling for abstaining and continuing in education.

In this essay, I have briefly outlined the behavioural perspective in Psychology. I will critically outline how a knowledge of behavioural techniques could be of help in a social care setting regarding people suffering from addiction.


Brooks, D. M., 2017. Tech Happy Life : Classical Conditioning and Smartphones. [Online] Available at: https://techhappylife.com/classical-conditioning-and-smartphones/[Accessed 23 October 2018].

Horvath, T., Kaushik, M., Epner, A. K. & Cooper, G. M., 2015. Classical Conditioning and Addiction, Mental Help. [Online] Available at: https://www.mentalhelp.net/articles/classical-conditioning-and-addiction/[Accessed 25 October 2018].

Lumen Learning, n.d. Psychological Perspectives: Lumen Learning. [Online] Available at: https://courses.lumenlearning.com/wsu-sandbox/chapter/psychological-perspectives/[Accessed 18 October 2018].

MacLauren, E., 2016. Understanding Tolerance, Dependence, and Addiction: Drugabuse.com. [Online] Available at: https://drugabuse.com/library/tolerance-dependence-addiction/#what-is-addiction-[Accessed 25 October 2018].

Malone, J. C., 2018. Research Gate: Ivan Pavlov Classical Conditioning. [Online] Available at: https://www.researchgate.net/publication/323129110_I_P_Pavlov_Classical_Conditioning[Accessed 24 October 2018].

National Institute of Drug Abuse, 2018. Understanding Drug Use and Addiction. [Online] Available at: https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction[Accessed 24 October 2018].

Queiroz, A. et al., 2015. From Theory to Treatment: Understanding Addiction from an Operant. Journal of Modern Education Review, 5(8), pp. 778-780.

Quinlan, A., 2017. 10 Facts about addiction: Independent.ie. [Online] Available at: https://www.independent.ie/life/health-wellbeing/health-features/10-facts-about-addiction-35582804.html[Accessed 24 October 2018].

Siegul, R., 2017. U Mass Lowell: Abnormal Psychology. [Online] Available at: http://faculty.uml.edu/rsiegel/47.272/documents/wk5_behavioralanalysis.pdf[Accessed 24 October 2018].

Thorndike, E. L., 1911. Classic in the Hitory of Psychology: Animal Intelligence. [Online] Available at: https://psychclassics.yorku.ca/Thorndike/Animal/chap5.htm[Accessed 24 October 2018].

Watson, J. B., 1913. Psychology as the Behaviorist Views it.. Psychological Review, Issue 20, pp. 158-177.


Internet Addiction: Causes, Effects and Treatments

Problematic social media use, also known as social media addiction, is a proposed form of psychological or behavioral dependence on social media platforms, similar to gaming disorder and other forms of digital media overuse. Generally, is it defined as problematic, compulsive use of social media platforms that result in significant impairment of an individual’s function in their life over a prolonged period of time. This and other relationships between digital media use and mental health have been considerably researched, debated, and discussed among experts in various disciplines, and have generated controversy in medical, scientific, and technological communities. Such disorders can be diagnosed when an individual engages in online activities at the cost of fulfilling daily responsibilities without regard for the negative consequences. When looking into these consequences, it makes one wonder if high internet addiction takes any psychological or any physiological toll on someone with this dependency. 

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 Before we look into the effects of internet addiction, we must look into the basis of research in internet addiction. Internet addiction can go by many names such as problematic internet use, internet dependency, pathological internet use, and internet addiction. When studying internet addiction, researchers focus on three main aspects of addiction based on intensity and progress of the addiction; intrusion, escaping reality, and attachment (Kim, J., & Haridakis, P., 2008). In prior research, many researchers have found both positive and negative effects of excessive internet usage. Some positive effects can include providing access to diverse information, such as health or education, lead to psychological well-being, and widen users’ social circles. However, there can also be some negative effects caused by the isolating platform that can lead to loneliness, less social interaction with family members and friends, and clinical depression (Kim, J., & Haridakis, P., 2008). Once we look into the effects of high internet usage we must ask, what makes addicts become so dependant on the internet? Some answers to this question could be because of boosted self-esteem and an increased sense of self-control in their lives that they would not get in their ordinary interactions (Kim, J., & Haridakis, P., 2008). Nonetheless, there are some issues with studying internet addiction such as having a clear definition of internet addiction compared to high internet usage or dependancy. In turn, this creates a grey area for defining high internet dependency. Overall this creates issues with any advancement in internet addiction studies and any explanations of the factors or conditions that lead to the psychological state (Kim, J., & Haridakis, P., 2008). Once we look into some more of the upfront effects of high internet usage, we can begin to look into the psychological effects this usage can take on users.

 There are a few theories surrounding the psychological toll that the internet takes on users with a very high intake. One of these theories is a neurobiological theory wherein it discusses the relationship between disorders such as depression and internet usage. This theory discusses how neurotransmitters may be abnormal in their transmission of chemicals like dopamine, which is often a large player in discussions involving addiction as it is a chemical that contributes to feelings of pleasure and satisfaction (Tokunaga, R. S, 2017).  Another theory that is touched upon is the cognitive-behavioral model which talks about pre-existing mental disorders like depression. A summary of this theory is that people who suffer from depression or loneliness may feel more confident through their online interactions, in turn making the user prefer online interactions compared to in-person interactions creating an addiction to these habits (Tokunaga, R. S, 2017). The next theory is explained through social cognitive and media use theory. Somewhat similar to the neurological theory Through these theories, we see an explanation that discusses the experience of solitude or anxiety that increases the likelihood of users expecting Internet use to mitigate the aversive feelings that accompany their distressed psychological conditions and make the Internet use habituated. Many people who fall into internet addiction enjoy the control and their own personal self-control issues in real life only heighten their dependency (Tokunaga, R. S, 2017). The final theory related to the relationship between psychological tolls and internet dependency is a strength model in self-control. The account of self-control failure illustrates that regulating dysphoric moods causes the body to preserve the energy needed to control the use of the Internet, particularly when the Internet is used to alleviate those emotions caused by depression and loneliness. The short-term resource depletion arising from regulating adverse moods is accelerating the growth of Internet habit (Tokunaga, R. S, 2017). These theories do link heightened increases in psychological issues based on internet dependency however they all state that these issues are predecessors to the dependency. While the internet can cause changes in someone’s depression or loneliness, it does not directly cause any psychological disorders.

 Finally, we will be focusing on the physiological effects that high internet usage has on users.

 Internet addiction can have many adverse effects on the mind and body. While there are many debates on the direct impact based on dependency to the internet, there are still some areas that have yet to be explored when it comes to this new-wave addiction. Even so, there are some visible and non-visible effects that can occur when someone is suffering from internet addiction. Through more research and studies maybe one day we can truly dive deep into internet and social media addiction.

Works Cited 

Kim, J., & Haridakis, P. (2008). The Role of Internet User Characteristics and Motives in Explaining Three Dimensions of Internet Addiction. Conference Papers — International Communication Association, 1–35. Retrieved from http://search.ebscohost.com.ezproxy.rit.edu/login.aspx?direct=true&db=ufh&AN=36957157&site=ehost-live

Tokunaga, R. S. (2017). A meta-analysis of the relationships between psychosocial problems and internet habits: Synthesizing internet addiction, problematic internet use, and deficient self-regulation research. Communication Monographs, 84(4), 423–446. https://doi-org.ezproxy.rit.edu/10.1080/03637751.2017.1332419

Younes, F., Halawi, G., Jabbour, H., El Osta, N., Karam, L., Hajj, A., & Rabbaa Khabbaz, L. (2016). Internet Addiction and Relationships with Insomnia, Anxiety, Depression, Stress, and Self-Esteem in University Students: A Cross-Sectional Designed Study. PLoS ONE, 11(9), 1–13. https://doi-org.ezproxy.rit.edu/10.1371/journal.pone.0161126


Psychosocial Implications of Substance Use and Addiction


This research paper will address Substance Use and Addiction, and the psychosocial implications associated with it.  This paper will also address the prevalence, incidence, symptoms, signs, investigations, and ethical considerations of substance use and addiction.



Substance addiction can be defined as a behavior that creates physical and psychological pleasure; however, the cost to the individual visibly outweighs the benefits. Substances, such as psychoactive drugs, that affect the brains pleasure zones will often result in dependence; these substances include anything from alcohol and nicotine, to a variety of legal and illegal drugs (Fleury et al., 2014; Babor, 2011).

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There is a numerous amount of psychological information on substance use and abuse, however, there is not one individualized theory focused on addiction.  Addiction is defined as a condition of being habitually or compulsively occupied with, or involved in something (Pinel, 2014). Substance addiction is often described as an unmanageable, compulsive act that is carried out even when it threatens the individual’s health and wellbeing; the individual often negates to see the potential harmful social consequences that follow the addictive behavior (Matusow & Rosenblum, 2014). The word addict carries with it a negative stigma that is born from the perception of society. Addicts are often perceived as uncaring, unreliable and unstable individuals; this perception does not necessarily apply to all addicts. Some individuals can function and manage their lives in such a way that no one is aware of their substance dependence; these individuals are referred to as functioning addicts (Smith, et al., 2014).

Theoretical Underpinnings

The Disease Model of Addiction

Psychological research has resulted in a theoretical model of addiction as a disease. The addiction model has neutralized the negative connotations associated with substance addiction and helps to encourage substance users to partake in addiction treatments and self-help meetings (Smith, et al., 2014). Consequently, the disease model has a limited view on the various treatment methods; it does not take into consideration the reality of the everyday life that substance users face. Moreover, the disease model neglects to address the social issues that arise from substance use and addiction (Fleury et al., 2014 and Smith, et al., 2014). When deciding on a treatment plan individualized for the substance user it is important that all treatment and intervention methods are thoroughly examined. Another psychological theory on substance use is the psychodynamic model. The psychodynamic model implies that addictive behavior is brought on due to the relationship between external events and the unconscious psychological processes of which the user stays oblivious (Klostermann & O’Farrell, 2013). The psychodynamic model has been successful in shedding light onto the importance of early childhood development and parental influences as possible origins of addictive behavior (Klostermann & O’Farrell, 2013).

The Behavioral Model of Addiction

Unlike the previously discussed theories on substance use, behavioral models of addiction base themselves upon the theory that the continued use of a substance will create elation, which in turn will intensify the need for the substance use to continue (Babor, 2011;Fleury et al., 2014;Goodwin & Sias, 2014). The need to ease withdrawal symptoms can be explained by reinforcing contingencies, however, the substance user will experience negative reinforcement due to taking the dose to help ease the pain (Fleury et al., 2014). Although the feeling of elation explains the continued use of the substance, it does not explain why some individuals are able to stop while other individuals become addicted. The social learning theory delves into this issue by explaining how social and psychological factors influence the emotional quandaries individuals find themselves in when they are using the substance (Fleury et al., 2014). Psychologists argue that the social learning theory explains human behavior by analyzing the continuous collective interaction between behavioral, cognitive and environmental factors; this theory looks at how an individual’s self-control and decision processes are affected (Babor, 2011; Fleury et al., 2014; Goodwin & Sias, 2014).

The Social Model of Addiction

The social learning theory focuses on an individual’s personal experiences from families, friends and other individuals. How individuals learn and perceive substance use, whether positive or negative, will affect the learning process and this in turn affects their behavior (Babor, 2011). Cognitive behavioral treatment, a popular addiction treatment bred from both the social learning theory and other behaviorist theories, helps substance user’s deal with wanting to make new life changes, managing their cravings, thoughts and develop new problem solving skills (Babor, 2011;Fleury et al., 2014;Goodwin & Sias, 2014).

The social model also takes into account the comorbid psychopathologies associated with addiction. These psychopathologies include depression, major depressive disorder, generalized anxiety disorder, panic disorder, trauma, oppositional defiant disorder, and conduct disorder, (Goldston, et al., 2009). These comorbid psychopathologies are categorized into internalizing and externalizing, with the former being more strongly connected to addiction (Verona & Javdani, 2011).

Numerous studies indicate that depression and hopelessness are directly linked to adolescent substance use; depression was present in 90% of the cases in which there was comorbidity (Goldston, et al., 2009). Substance use acts emerge as a result of a vulnerable personality (psychopathology, increased traumatization, high harm avoidance, etc.) and additional stressors, as well as the presence and interaction between internalizing and externalizing factors. Stressors can precipitate an individual’s emotional distress, which may be alleviated by their social support, family connectedness, and coping behaviors. Comorbid psychopathologies, as well as substance use, weakens these effective coping behaviors and increase exposure to stressors, ultimately increasing the risk of substance use (Ruchkin, et al., 2003).

Substance Use and Abuse

Illegal substance use and underage alcohol consumption is a prevalent issue within society today. Early experimentation with drugs and alcohol have an influencing role on how individuals view substance use in the future; individual that have a positive experience will be more susceptible to use again. Individuals who are social, or recreational, substance user also have the potential to become addicts due to their psychological state and what substance they are using. Individuals who are deemed “social users” can control what substances they take and the amount they use, however, social users still share the risk of having their substance use interfere with their home and work lives. When the individual begins to lose control of their consumption and how much they are consuming, they begin to become less of a social user and more of an addict. Once the individual cross the line from social user to addict, their primary focus is on how and when they can use again. Addiction is no different whether you are addicted to a substance, alcohol, or food (Pinel, 2014).

All drugs affect the brain chemical balance, no matter what the substance, this is known as the brains reward system. When analyzing the brain of a non-addict it is different from that of an addict. When an individual uses a substance there is a surge of dopamine and other pleasure messengers, however, these quickly desensitize due to the adaptivity of the brain; this adaptation results in withdrawal symptoms.  Short-term substance use does not affect the brains chemical makeup contrary to long-term substance use (Pinel, 2014). If an individual continues to abuse substances permanent neurological changes begin to affect the chemical makeup of the brain; these changes in the brain affect behavior and/or the ability to make rational decisions (Pinel, 2014). These chemical changes in the brain results in the individual’s persistent substance usage in hopes to achieve the “high.” Individuals may become addicted primarily to help deal with withdrawal symptoms (physically dependency), stress issues or simply to avoid everyday reality (psychological dependency) (Pinel, 2014).

Research suggests that addiction runs in families; however, it may not be merely a function of the parent-child relationship or imitation, but rather an inherited trait. In 1998, Statham and colleagues conducted a twin study in which the heritability quotient was 55%. Serotonin metabolism and receptivity is the focus in the attempts to pinpoint the mechanism through which genes affect behavior (Wenar & Kerig, 2006). Others argue that an individual’s biological genes make up may have a role to play regarding a person’s addiction. If this is the case, then if an individual’s parents were alcoholics or drug addicts then they would be at a greater risk of following the same path resulting in the individual becoming an addict them self. This could possibly prove that in a minority of cases addiction could be genetic. The individual will not necessarily be born a drug addict or alcoholic, but is however, more at risk of becoming involved in substance use later in their life.

Additionally, research suggests that genetics plays a role in an individual’s susceptibility to addiction (Fleury, et al., 2014).Once a substance user decides to cross over the line of being in control of their thoughts and actions to achieve the “high” they become addicts; they have no self-control and the chemical effect on the brain has made the “high” unachievable. The individual’s lack of ability to control their substance use is now looked at as the disease of addiction. It is, however, achievable for the brain to recover from long-term substance use. For this to be achieved it involves long term abstinence from the use of chemical changing substances (Matusow & Rosenblum, 2013).


If there is to be progress in the disease from the abuse of drugs and alcohol, continuing to educate society about the possible dangers using can have not only to themselves, but also to their family and friends. By continuing to do this we will have a better chance of witnessing a decline in the abuse of drug and alcohol substances and by large an improvement in everyday living. Abstinence as previously mentioned is the only viable treatment program regarding the disease model of addiction. However, there are suggestions that in the process of recovery relapses are all too common (Matusow & Rosenblum, 2013).

Ethical Considerations

To help fully appreciate addiction there must be a more integrated approach which will take the different processes into consideration. Smith, et al. (2014) states that there are five stages that individuals will go through when experiencing behavioral changes. The first stage is when the individual is ignorant or unaware that they have a problem and have no wish to change. Stage two looks at the individual and how they begin to consider changing their behavior but have not yet made any attempts to do so. Stage three focuses on the acceptance that there may be a problem and begins to make changes. The fourth stage is when the individual begins to put their plans into action to help change their behavior. The final stage is when the changes made are maintained and the individual is dedicated in making lifestyle changes to allow this to be maintained (Smith, et al., 2014). A successful addiction treatment should encompass both the biological factors as well as the behavioral and social factors that influence individuals. Although there is no concrete theory and treatment on substance use and addiction, much improvement has been made in understanding this complex disease.


Babor, T. F. (2011). Substance, not semantics, is the issue: comments on the proposed addiction criteria for DSM-V. Addiction, 106(5), 870-872.

Fleury, M. f., Grenier, G., Bamvita, J., Perreault, M., & Carón, J. (2014). Predictors of Alcohol and Drug Dependence. Canadian Journal Of Psychiatry, 59(4), 203-212.

Goodwin, J. g., & Sias, S. M. (2014). Severe Substance Use Disorder Viewed as a Chronic Condition and Disability. Journal Of Rehabilitation, 80(4), 42-49.

Klostermann, K., & O’Farrell, T. J. (2013). Treating Substance Abuse: Partner and Family Approaches. Social Work In Public Health, 28(3/4), 234-247.

Matusow, H., & Rosenblum, A. (2013). The Most Critical Unresolved Issue Associated With: Psychoanalytic Theories of Addiction: Can the Talking Cure Tell Us Anything About Substance Use and Misuse?. Substance Use & Misuse, 48(3), 239-247.

Pinel, J. (2014). Biopsychology Plus NEW MyPsychLab with eText-Access Card Package (9th ed). Upper Saddle River, NJ: Pearson

Smith, J. L., Mattick, R. P., Jamadar, S. D., & Iredale, J. M. (2014). Deficits in behavioral inhibition in substance abuse and addiction: A meta-analysis. Drug And Alcohol Dependence, 1451-33.


Issue of Social Media as an Addiction

We all know that feeling of constantly having the need to check our phones every five seconds hoping we received a new notification. We live in a society where we compare ourselves to unrealistic ideals and rely on memes for instant gratification. In our modern technological world, a new slang is created almost every day to justify what we are saying as there just are insufficient words in a dictionary. We can now shop, talk, and work all from the comfort of our bed. Oh, isn’t technology simply amazing?! Social media is an ever-changing mean of communication. When we think about social media, the first thing that pops into our head are likes, hashtags, Instagram, Twitter, Facebook, etc. Social media has evolved into something much greater than that “About 168 million people in the United States own a smartphone in 2014 and spend over 30 hours each month using an average of 27 applications” (comScore.com, 2014; Nielsen.com, 2014b) (Lee, 45). That’s a lot of time spent scrolling through your phone,

 contemplating at how others live, and if that isn’t troublesome than I don’t know what is. Like every good thing has a bad side, Social media too, has a dark side; it is responsible for the dumbing down of our society and the reason we’re becoming addicted.

Social media has facilitated how we communicate with loved ones all across the globe and has provided information needed with a touch of a button. “Mayo Clinic Center announced that they’ve created the formation of the Social Media Health Network, a group dedicated to using social media to promote health, improve health care and fight disease” (Mayo Clinic).  This idea is supposed to be beneficial to both the clinic and those using their network. Although this might seem like it’s filled with good intentions, it seems as though there using one’s obsession of being glued to the phone, to supply an indolent way to diagnose what’s wrong with us. Ironic, isn’t it.  Wouldn’t you much rather get treated by a doctor, who’s gone through college and has the experience, rather than searching your symptoms on the web, without a thorough analysis? That must not be a problem to those checking their symptoms from bed, not knowing that they might be suffering from Nomophobia, a problem in which people experience

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 anxiety from not being on their phones. But who knows maybe they can check on the Mayo Clinic website to see what’s going on with them, maybe it’s only a simple cold? Doctors similar to those at Mayo Clinic, aren’t seeing what’s best for the people, only what’s best for them. And just like them, there are folks who believe “there are hints of moral panic in the notion of a mental health epidemic in young people, and the supposed harmfulness of the internet. Reactions to transformative new technology are understandable but often exaggerated (McCrae).  Many believe that the exaggeration that social media isn’t safe is because many don’t fully grasp what social media is, but many are just in denial on what social media actually isn’t. The same author of this article then realizes that there are negative phycological effects due to the use of social media.  More in the ways that although it’s not mainly social media and the apps themselves that do harm, but more as in the content and how weak-minded people and those with addictive personalities are more likely to fall into the rabbit hole of what social media is. 

According to Rosen’s article in America Now, “Scientist have documented that we experience dopamine rush when we receive a new email in our inbox. Dopamine is a chemical found in the brain, linked to a human sensation of pleasure (93). Eating your favorite meal, watching your favorite movie, or receiving multiple likes in your most recent photo, all release that ‘feel-good feeling”. The downside is that although it’s a great feeling, similar to a drug, the body will start asking for more, causing addiction. It hurts those who can’t differentiate reality from the fantasy that social media is.  Society, into their phones so much find themselves scrolling through their social media while in the middle of something important. Have you found yourself doing that today? Well there are 7.7 billion people living in this earth, imagine how many of those people are scrolling through their phone at this instant. 57% of the world population is now connected through the internet and the average user spends

 about 6 hours online daily, according to research by Hootsuite media. That’s time wasted, you can be doing more productive things with that time like reading a book, learning a new hobby, or finding ways to make more money. And if that still doesn’t seem like a big deal, then just think about all those people who can’t let go of their phones who now have eye sight problems. Studies have shown that the blue light that your screen transmits causes eye damage. No matter how beneficial people say technology is, some things aren’t meant to be overused and there should be a limit on how much time we spend on the internet.

 It is safe to say that social media is affecting us in a way that no one thought it would by giving us unrealistic standards. Everyone is still fairly excited and curious, more now than ever because of the benefits that come along with having a big following. From just having ten-thousand followers and a good social media page you’re capable of working with brands to collaborate together and promote their products, in exchange for free merchandise. On the other hand, if you have even more followers than that, it is possible for you to get paid from posting a photo and get invited to exclusive events. Someone mentioned the other day that our Instagram influencers are our modern-day Gods; They have the followers and believers who trust everything they say. Instagram is one of those platforms that are filled with beautiful people living the perfect life, but what people forget is that there’s this magical website called photoshop, and oh does that thing do wonders. Many don’t realize that it’s one thing to flex (show off) on Instagram and the other to actually live up to that lifestyle. I have friends who are influencers with thousands of followers, who started out just wanting to show people a little about themselves. Now that it has become a job and their followers are demanding new content, they sort of lost themselves and forget why they started in the first place. When society see’s that people get a lot of love by acting and looking a certain way, it triggers people to follow

 into those footsteps. Hurting themselves for having a mindset that likes and followers are what define them.  All things considered, Social media is meant to bring people together but more people should learn to be themselves and not give into what the people want because at the end of the day, it’s your life and you need to choose to live it as stress free and blissful as possible.

Social media has come a long way, who would of thought in a world   technology a couple years ago, that this is where we’d be now? You might not look at it this way, but it is affecting the way we critically think and interfering with kids’ education. Kids are taught to use phones at such a young age, that a way to keep kids from crying is to give them a tablet with cartoons playing. Kids in school are more likely to cheat by quickly and discreetly navigating the web to find the answers to an exam. No deep thinking is required when researching a topic because there are already many articles talking about the topic being searched. Technology is just making our lives so much easier that we don’t even have to think as long as we know how to type and read, we can quickly find answers to our problems. That might not be a beneficial thing to our health, as our brains like to soak in new knowledge to help ourselves grow. It seems that as the days go by, we keep getting sucked into our phones that maybe at one point they really are going to be the literal definition of smart phones and take over us.

Nonetheless, it is safe to say that although there are many contradictions as to what’s best for us, at the end of the day social media is an amazing tool in our lives. If it weren’t for social media, we wouldn’t know what was going on around the world or communicate with loved ones across the globe. But it is also undeniable that social media is ruining many people’s lives. Things have to be done in moderation because too much of something good can only cause harm. Scientific evidence proves the harm behind the use of social media and unless you want to make it an addiction or rely on it for knowledge, then I’d suggest limiting your time on your phone. Doing something productive that’ll stimulate growth like learning a new hobby is a way to start. 

Work Cited

“What  Social Media?” How the World Changed Social Media, by Daniel Miller et al., 1st ed., vol. 1, UCL Press, London, 2016, pp. 1–8. JSTOR, www.jstor.org/stable/j.ctt1g69z35.8.

Thompson, Robin. “Radicalization and the Use of Social Media.” Journal of Strategic Security, vol. 4, no. 4, 2011, pp. 167–190. JSTOR, www.jstor.org/stable/26463917.  (Political terrosism whats social media rabbit hole)

“Conclusion: Why Do They Love Social Media?” Social Media in Emergent Brazil: How the Internet Affects Social Mobility, by Juliano Spyer, vol. 10, UCL Press, London, 2017, pp. 185–198. JSTOR, www.jstor.org/stable/j.ctt1wc7rdn.12. ( low income families brazil)

“Travel, the New Currency of Brand Making and Influencer Marketing.” PR Newswire, Jun 12 2017, ProQuest. Web. 27 Apr. 2019 .   (INFLUENCERS)

Lee, E. Bun. “Too Much Information: Heavy Smartphone and Facebook Utilization by African American Young Adults.” Journal of Black Studies, vol. 46, no. 1, 2015, pp. 44–61., www.jstor.org/stable/24572928.

Kaul, Vineet. “The Changing World of Media & Communication.” OMICS International, OMICS International, 22 Apr. 2012, www.omicsonline.org/open-access/the-changing-world-of-media-and-communication-2165-7912.1000116.php?aid=6473.  (no but save incase)

“Mayo Clinic Center for Social Media Launches Global Social Media Health Network.” Business Wire, Sep 28 2010, ProQuest. Web. 28 Apr. 2019 .  (nayo clinic)

McCrae, Niall. “Social Media Is Not to Blame for Depression in Young People.” The Conversation, 24 Sept. 2018, theconversation.com/social-media-is-not-to-blame-for-depression-in-young-people-73635.

Hootsuite Media Inc. “Digital in 2019 – Social Media Marketing & Management Dashboard.” Hootsuite, 2019, hootsuite.com/pages/digital-in-2019.



Interventions for Drug Addiction: Case Study

Many attempts have been made to arrive at a universally acceptable definition of addiction and what causes addictive behaviour but the matter still remains unresolved. People often define addiction as drug abuse and misuse. To Krivak (1982,p.83), ‘Addiction will be defined as a behaviour pattern characterised by an ongoing and overwhelming preoccupation with the used of a drug and the securing of its supply.’
This definition could also say the addict is, ‘Someone who is involved with an activity to such an extent that it the major focus of his or her life’, (McAllister et all., 1991,p.5).
For my assignment, I have chosen a client within the criminal justice system that has an addiction problem with drug misuse. He has been involved with the criminal justice system because of his offending behaviour relating to illegal drugs. I am basing my assignment on this client. I am going to discuss in my assignment, drug users and the criminal justice system, the psychology of addictive behaviour, Care planning and different options of planning and assessment, the initial referral and the in-depth assessment, methods of intervention and models of care and drug problems in prisons within the criminal justice system.

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Where there is an addiction to drugs, most drug users at some time or another come into contact with the criminal justice system. This is how my client got involved with the system. Some drug users spend periods of time in prison as a result of drug-related offending behaviour. There is an alternative to custody and these include fines, community service, probation and bail, which is subject to certain conditions such as participation in drug treatment programmes. My client is subject to certain conditions that he participates in a drug treatment programme.
Criminal justice orders can be subject to conditions of residence for the offender. For drug service workers, close liaison with practitioners in the criminal justice field of work is normal practice. Joint care plans are carefully and sensitively devised to help both services work with the drug user in collaborative and constructive ways. Criminal justice practitioners are expected to work with offenders to achieve specific objectives and these are not always compatible with drug service objectives, for example, reducing drug-related offending behaviour rather than getting rid of it altogether (Robertson, 1998, p.389).
My client has an addiction to drugs. The psychology of the addict involves behaviour that takes a repetitive form and is associated with increases of anxiety. Some behaviours that take a repetitive form are associated with increases or decreases in anxiety and these are considered compulsive behaviours. These types of behaviours can include drug addiction, gambling and exhibitionism. However there are important distinctions between these types of behaviour and action and true compulsive behaviour. Firstly addictive behaviours involve a pleasure-seeking component, which is not in compulsive behaviours. Secondly, the anxiety involved with the performance of criminal activity is appropriate in light of social sanctions. Obsessive-compulsive patients experience anxiety that is inappropriate to the situation (Oltman, 1995,p11).
There are different options of planning and assessing with substance misuse offenders in the criminal justice system. For social workers, assessment is a key task and it will determine whether or not a care plan is needed for the offender of if a management service is needed. The NHS and Community Care Act (1990) provides guidance on procedures for assessment for people who are entitled to community care services. The assessment process includes, the initial referral, the initial assessment and the in-depth assessment. The assessment process should be needs led and not service-led. Community care services are greatly in demand and the screening process is used to determine who needs the treatment the most. Drug agencies undertaking assessment may receive referrals from the criminal justice system or other agencies. Basic referral forms are filled in with the details of the service user, such as factors and the reason for referral. My client has been referred from the criminal justice system to a drug agency for assessment.
The initial interview with the service user will determine whether or not they need a more in-depth assessment or a formal care plan. Most local authorities have certain criteria and priority levels to which they can base their response on. The service user is told what is involved in the assessment, is told about confidentiality policies and whether or not there will be any participation of others. The service users are told what to do if they want to use complaint procedures or appeal if they are against any decisions made at or after the assessment. The initial assessment will determine the seriousness of the problem and the level of need required.
My client has more complex needs with his addiction problems so he would require a more in-depth formal assessment so that a care plan can be made for him. This assessment will include personal details, family and relationships, social details, significant life events, social supports and networks, comprehensive history of addictions and associated problems. The assessment will also include, treatment history, risk behaviour, criminal history and current offending behaviour, financial status, physical health, mental health problems, past and present, self concepts, perceived needs and the level of motivation to address these needs, personal resources and abilities, resources and abilities of partners and carers, other agency assessments and specialist assessments and the conclusions and suggested interventions of the assessment.
Robertson (1998,p.376) suggests that care planning should involved developing a package of care, which will meet the client’s needs. Care plans are systematic approaches and include all the care and treatment that will be provided and the desired outcome. Care plans are monitored measured and reviewed and will involve the client, service provider, an assessor and a care manager. The care plan will involve information gathered at the assessment in an easy to monitor format and will illustrate the behaviours that need to be addressed and it will have separate sections for identifying the needs of the problem.
Partnerships between the criminal justice system and the treatment agencies direct substance-misusing offenders to the appropriate services. There are many initiatives aimed at encouraging substance misusers to take part in appropriate treatment that will help them. In the UK there are twelve step agencies that are also know as the ‘Minnesota method of treatment’. These agencies are funded through statutory sources. The aim of these agencies is to treat the dependence on drugs to help reduce drug misuse and to help the client give up drugs completely when they feel ready to do so. Three intermediate aims are to help resolve the underlying problems that contribute to drug misuse, to help the client gain more control and minimize harm also known as harm minimization (Keene, 1997,p.223).
The Government produced a drug strategy in 1998 in the UK called, ‘Tackling drugs to build a better Britain.’ This was updated again in 2002. The strategy sets out the range of interventions and policies to help reduce harm caused by using illegal drugs by the year 2008. The drug intervention programme used to be known as the criminal justice interventions programme. The government aims to cut crime related to drug use. This strategy uses the criminal justice system to help direct offenders who used drugs out of crime and into treatment.
There are different kinds of interventions used by drug service workers. Psychological interventions are very useful when it comes to help treat someone with a drug addiction. Professional psychotherapy is very effective and good quality drug counselling can also be very effective. Psychological interventions are, cognitive behaviour therapy, motivational interviewing, and the twelve-step treatment program that I discussed earlier and relapse prevention. Some people think that complementary and alternative therapies are useful, but there is not enough evidence in the population to back up this claim.
The model of care, introduced by the National Treatment agency (NTA), is a framework that is used by Drug Services to ensure that the services provided are consistent and meet the needs of the service user. The framework is categorised by easy to understand tier levels and treatment levels. Tier one, includes primary care by health care professionals and general practitioners that provide medical services along with probation and housing services. Tier two (Open Access Services) offers a range of drop in street agencies that offer advice and support for stimulant users and substance misusers are able to drop in when there is a crisis. Tier three (Community prescribing services) is mostly geared towards opium user. Tier three, (Structured day programmes) are geared into providing education about drug misuse, and provide training for work skills and give advice about practical issues. Tier four, (Residential Care) has different systems in place for entry in different areas for entry into residential care. The social services community care assessment team usually deal with the funding.
Another option for the substance misuse offender is motivation to change. Motivational interviewing is based on using the motivational change model. The model consists of five stages with stage one being the pre-contemplation stage, stage two the contemplation stage, three the action stage, four the maintenance of change and five the relapse stage. Prochaska and DiClemente are two best-known authors on the importance of individual motivation in dependency treatment. The authors developed the motivational change module from their work with smokers. They use a
Cognitive behavioural approach method and their interventions are concerned with cognitive and behavioural change (Prochaska and DiClemente, 1983,p.390).
The control of drug misuse is a big problem in prisons. People are much more likely to use drugs in prison because of stress, anxiety and boredom. These levels are higher for substance misusers in prison so they would be more likely to take health risks. Drug treatment in prison could be approached the same way, as it is in the community with regimes to reduce drug related harm, rather than prevention.
Because of the extent of my client’s addictive behaviour he has had a formal in-depth assessment done so that we can meet his needs. This has resulted in a care plan being made up for so that we can provide services for him and carefully monitor his progress. We have liased with other professional health services and we have had a full mental health assessment done for him. We have considered his past history of using drugs and the amount of offending he has done in the past and the length of time he has been involved in the criminal justice system. We have noticed that he has also had mental health problems in the past and that he suffers from depression. The client did not go into custody this time because of his substance offending behaviour instead he was given a probation order subject to certain conditions that he participate in a drug treatment service. We contacted drug service workers who were happy to help my client as long as he was willing to accept help. My client says that he does want to change his behaviour and put an end to his substance misuse. He has tried in the past to give up but this has always lead to a relapse. After careful consideration and after weighing up all the options of treatment for my client I decided that psychological intervention along with drug therapy was the best way forward to help reduce his drug dependency. I have decided that professional psychotherapy and relapse intervention would be the best option for him because other options have not helped him in the past. We are also going to offer him good quality counselling. My client has told me that spending time in custody has not done him any good. He told me that he gets very depressed when he is inside and this leads to more dependency on drugs. Our goal is to help him stay out of custody and reduce his dependency on drugs. We will continue to monitor, measure and review the clients care plan and see whether or not his dependency and addiction are getting better. As substance service workers our goal is to meets the needs of the service user and in this instance it is to reduce substance addiction and the long term goal is to eradicate substance misuse altogether.
In order to intervene effectively where there is addictive behaviour, social workers need to be able to assess and plan appropriate treatment. For my assignment I have chosen a client within the criminal justice system that has an addictive behaviour. He is a drug misuse offender and he has been involved with the criminal justice system for a few years now. I have discussed a bit about the psychology of addictive behaviour and how my client was referred to me through the criminal justice system. I have discussed the methods of assessment and the different options available. I have discussed the most suitable option for my client who I feel has deeper problems to address than some other substance misusers I have encountered. In this instance I felt that my client would benefit from a psychological form of intervention that would include psychotherapy. There are different types of psychotherapy; these are behaviour therapy that helps the client put an end to undesirable habits or certain fears that they have. Cognitive therapy is a method that tries to show the client that certain thoughts that they are having are not good for them and that they are negative. The therapist will then try to get the client into thinking more positive thoughts in order that the persistence of negative thoughts will eventually fade away.
Drug therapy is also called by the name of pharmacotherapy and it is a part of psychotherapy. The approach here with this method of intervention is to calm the person down using certain anti-anxiety drugs so that they permit the other therapies to have effect. The negative side is that sometimes these drugs encourage psychological dependence and the anxiety that was there before might return again. Some addictions such as obsessive – compulsive disorder have been successfully treated using certain antidepressant drugs.
The types of interventions I have discussed do not always work for everyone. Social workers need to analyse the situation very carefully and sensitively when working with addictive behaviours. This is because it is a very sensitive area and if treatment goes wrong the client could go back to their old habits of substance misuse and become a part of the drug culture again. The aim is to reduce offending and minimise the number of substance misusers by putting carefully controlled care plans into place to address their needs. The intervention method that was used on my client was very successful and I am happy to say that my client has cured his addictive behaviour. It is important that assessments are done very carefully and to take into consideration all the important facts of the client. It is also important for social workers and other drug service workers to gain the trust of the client because without this there is less change of the client willing to accept treatment.
Barber, J. (2002) Social Work with addictions, 2nd ed. Basingstoke: Palgrave Macmillan.
Keene, J. (1997) Drug Misuse; Prevention, Harm, minimisation and treatment. London: Chapman & Hall.
Krivanek, J. A. (1982) Drug Problems, People Problems: Causes, Treatment and Prevention, Sydney, Allen & Unwin.
McAllister, I., Moore, R. and Makkai, T. (1991) Drug users in Australian Society: Patterns, Attitudes and Policies, Melbourne, Longman Cheshire.
Oltman, T. F. (1999) Case Studies in Abnormal psychology, New York: Chichester. John Wiley & Sons.
Prochaska, J. O. and Diclemente, C. C. (1983) Stages and Processes of self-change of smoking: Towards a more integrative model of change. Journal of consulting and Clinical Psychology.
Robertson, R. (1998) Management of Drug users in the community, a practical handbook. Arnold publishers.

Is Sugar Addiction a Substance Use Disorder?

An Examination of Sugar Addiction as a
Substance Use Disorder
In the last decade, many studies have supported the addictive nature of sugar. In this examination of sugar addiction, we explore the parallels with substance abuse disorder and highlight the effects on the brain and body as well as the psychological and biological risk factors that may make an individual vulnerable to sugar addiction. We theorize that defining sugar addiction as a substance abuse disorder in a future version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) will change policy to improve public health, and minimize the costs of metabolic disorders like diabetes, obesity, and heart disease on the economy.
Keywords: sugar addiction, substance use disorder, dopamine,
impulsivity, obesity
Worldwide obesity rates are rapidly rising. In 2016, an estimated
30% of Americans over the age of 18, and almost 20% of young adults were overweight
or obese, as defined by a body mass index (BMI) greater than 30 (Centers for
Disease Control and Prevention, 2016); and they are projected to increase to
80% by 2023 (Wang, Beydoun, Liang, Caballero, & Kumanyika, 2008). Between 29%
and 47% of obese individuals meet the criteria for binge eating disorders (BED)
(McCuen-Wurst, Ruggieri, & Allison, 2017). However, we suggest in this review
of the literature that the food addiction model is a more appropriate mechanism
when looking at correlates and causes of the development of eating disorders
and metabolic disorders, including insulin resistance, diabetes, and obesity. The
DSM-5 criteria for BED is limited in that it focuses largely on behavior, distress
and shame caused by the eating disorder, and lacks acknowledgment of the
neurobiological vulnerabilities and effects (American Psychiatric Association,
2013a). Alternatively, the food addiction model proposes that food, especially
highly palatable, processed foods that are high in sugar, fat and/or salt are
addictive (Davis & Carter, 2014), and therefore may be the underlying cause
of BED and metabolic disorders, including obesity. For this examination, we mainly
focus on the addictive nature of sugar, as the majority of food addiction
studies have shown that sugar intake is more addictive than fat or salt, and highlight
the numerous biological and psychological parallels to substance (Avena,
Bocarsly, Rada, Kim, & Hoebel, 2008; Avena, Rada, & Hoebel, 2008; Davis,
Loxton, Levitan, Kaplan, Carter, & Kennedy, 2013; Hoebel, Avena, Bocarsly,
& Rada, 2009; Hone-Blanchet & Fecteau, 2014; Ifland, Preuss, Marcus,
Rourke, Taylor, Burau, Jacobs, Kadish, & Manso, 2009; Page & Melrose,
2016; Tran & Westbrook, 2017; Wong, Dogra, & Reichelt, 2017).

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It is well known that addictive drugs activate the
dopaminergic reward pathway. The mesocorticolimbic pathway, which includes the
ventral tegmental area (VTA), nucleus accumbens (NAc) and the frontal cortex,
is especially implicated in the reinforcement of the use of these substances.
These areas release high levels of dopamine, which produce a euphoric state,
and help form “liking” motivations and positive associations toward the
addictive substances. However, as the drug is repeatedly consumed, tolerance
builds in the body, and “liking” becomes “wanting,” resulting in reduced
pleasure, and physiological dependence that necessitates increased consumption
(Reeve, 2015).
Food addiction studies have shown that while a variety of
foods lead to the release of dopamine, sugar activates the dopaminergic pathway
in a way that mirrors addictive substances, and leads to bingeing, tolerance, cravings,
dependence, and subsequent withdrawal symptoms when deprived (American
Psychiatric Association, 2013b; Avena et al., 2008; Davis & Carter, 2014;
Davis et al., 2013). As sugar is over-consumed, tolerance grows and bingeing
with increased amounts of sugar are needed to obtain the same pleasurable
effect. This is suggested to be due to the down-regulation of dopamine
receptors (Avena et al., 2008; Davis, Patte, Levitan, Reid, Tweed, &
Curtis, 2007; Hoebel et al., 2009; Ifland et al., 2009, Loxton & Tipman,
2017). Thereafter, “wanting” or cravings are suggested to be due to the
imbalance of hormone signals that results in high anticipation and high
sensitivity to sugar when it is consumed. In a study conducted by Lindqvist,
Baelemans, and Erlanson-Albertsson (2008), rats that were given a sugar
solution showed a 40% increase in ghrelin, the hormone that triggers appetite;
in contrast to a significant decrease in leptin and peptide YY, two hunger-suppressing
hormones; and a significant down-regulation in mRNA expression of additional hunger-suppressing
peptides. This imbalance of appetite hormones and gene expression were
hypothesized to have resulted in bingeing and tolerance, as demonstrated by a doubling
of the drink consumption compared to control-group rats given water. Lastly, animal
studies on sugar addiction have shown that sugar withdrawal mimics opioid
withdrawal, and presents with depression and anxiety when deprivation of sugar
occurs (Avena et al., 2008; Avena, Rada, & Hoebel, 2008; Hoebel et al.,
2009; Hone-Blanchet & Fecteau, 2014; Ifland et al., 2009). The numerous
studies in sugar addiction that overlap with the different stages of substance
use disorders provide strong biological support for sugar addiction to be classified
as a substance use disorder.
Further adding to the biological susceptibility of sugar
addiction, Davis et al. (2013) found enhanced dopamine transmission was due to
six genetic mutations linked to the dopamine reward pathway; and that association
between increased dopamine signaling and multilocus genetic profile scores was
significantly higher in participants with high reward sensitivity and high risk
for food addiction. These neurological changes and genetic vulnerabilities support
tolerance and dependence that may result from a frequent flooding of dopamine and
a reduction of receptors as seen in substance use disorders.
Likewise, psychological traits like impulsivity and poor
emotional regulation, have been found in both substance use disorders and sugar
addiction. Impulsivity, as it relates to immediate gratification and deficits
in behavioral inhibition, was positively correlated with sugar addiction.
However, sensation-seeking, as an impulsive personality trait, was negatively
associated with sugar addiction, and theorized to be due to the lack of arousal
and stimulation from eating food; “those who are risk seeking and reward-driven
might seek out experiences involving greater levels of arousal and stimulation
(Pivarunas & Connor, 2015; VanderBroek-Stice, Stojek, Beach, vanDellen,
& MacKillop, 2017). Poor emotional regulation and low distress tolerance
were also positively associated with sugar addiction, and the consumption of
sugar was hypothesized to activate the pleasure center countering the negative
emotional state and further reinforcing the reward of sugar intake behavior (Kozak
& Fought, 2011; Pivarunas & Connor, 2015).
Equally important in the comparison between sugar addiction
and substance use disorders are the detrimental effects on the brain and body’s
functions, such as cognitive impairment and metabolic disorders. Reversible cognitive
impairments in decision-making, motivation, spatial or place-recognition memory
were recently identified in studies with rats (Tran & Westbrook, 2017; Wong,
Dogra, & Reichelt, 2017). However, in a study conducted by Page and Melrose
(2016), high levels of circulating sugar and insulin levels dulled food cues, reducing
hypothalamic activity, and negatively affecting neural food processing, which
over time increased the risk for insulin resistance, type 2 diabetes, and
obesity. A separate study found that the overconsumption of sugar increased
levels of free fatty acids, triglycerides and cholesterol in the blood (Lindqvist,
Baelemans, & Erlanson-Albertsson, 2008), which are confirmed risk factors for
developing in heart disease and strokes in humans (National Institute of
Health, 2005; American Heart Association, 2017). The relationship between sugar
addiction’s detrimental effects and long-term illness are apparent in the
literature, and is analogous to the relationship between substance use and
Current treatment options for food or sugar addiction are
limited to exercise, which addresses biological pathways; and mindfulness,
which emphasizes psychological processes. Exercise serves as a protective
treatment against metabolic disorders and food addiction via increases in brain-derived
neurotropic factor (BDNF), a neurotransmitter that plays a major role in
neuroplasticity, and in the regulation of food intake, physical activity, and
glucose metabolism (Codella, Terruzzi, & Luzi, 2017). Whereas, mindfulness
addresses the dual process model of health behavior, which states that there
are interactive automatic (implicit) and controlled (explicit) psychological processes
that result in addictive behavior. Implicit, automatic processes include
intentions, approach and avoidance tendencies, and emotions, meanwhile explicit,
controlled processes include reflective action (Hagger, Trost, Keech, Chan,
& Hamilton, 2017; Tang, Posner, Rothbart, & Volkow, 2015). In 2017, Kakoschke,
Kemps, & Tiggemann showed that a two-pronged approach-modification protocol
successfully retrained participants to avoid unhealthy food by 1) reducing the
approach bias toward unhealthy food, and 2) increasing the approach bias toward
healthy food. Another study showed a high approach tendency for healthy food
buffered against the stress of hunger and wanting for unhealthy food (Cheval,
Audrin, Sarrazin, & Pelletier, 2017). Mindfulness was also found to
regulate emotional reactivity to internal and external cues (Fisher, Mead,
Lattimore, Malinowski, 2017). Unfortunately, available treatment options have
low generalizable, replicable success as they fail to provide a streamlined approach
to sugar addiction and/or address neurobiological vulnerabilities and negative
Neither sugar nor food addiction is currently defined in the
DSM-5. The only consistent measure of food addiction is the Yale Food Addiction
Scale (YFAS), a survey developed in 2009, and it is used in studies reliably as
its questions are based on DSM-IV addiction criteria (Gearhardt, Corbin,
Brownell, 2009; Gearhardt, Corbin, Brownell, 2016). As mentioned earlier, food
addiction and BED are not reciprocal disorders, therefore acknowledging sugar
addiction as a substance use disorder in a future DSM may increase evidence-based
research that strongly implicates genetic and brain pathways, which may lead to
early prevention, reduced stigmatization and diverse treatment options that address
the psychological as well as neurobiological vulnerabilities through
medication, and even gene therapy. Further research and government regulation can
also limit the pseudo-science funded by sugar and packaged goods companies. For
example, in reviewing the literature, two studies were found that denied sugar
and its addictive properties (Benton, 2010; Markus, Rogers, Brouns, &
Schepers, 2017); they were funded by Coca-Cola and the World Sugar Research
Organization. Similar to the studies conducted by the tobacco industry, the
information countering sugar addiction can be confusing and deceptive to
consumers. Government regulation of the sugar industry, like the tobacco
industry can result in a decrease of sugar addiction and its harmful health effects.
Lastly, there is also a large benefit to public health and the economic costs in treating sugar addiction like a substance use disorder. The costs to treat diabetes, a disease directly related to increased blood sugar levels and insulin resistance was $245 billion in 2012 (Centers for Disease Control and Prevention, 2017). These costs do not include comorbid diseases like obesity, hypertension, and hyperlipidemia. Obesity alone is projected to cost upwards of $957 billion by 2030 (Wang et al., 2008). Therefore, prevention of these life-long metabolic disorders by addressing the addictive properties of sugar can potentially reduce the burden on global health and economic systems in a great way. References
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motivation and spatial memory, but not impulsivity measured by operant
delay-discounting. Behavioural Brain
Research, 327, 144-154. doi:10.1016/j.bbr.2017.03.029

Mindfulness as an Intervention for Alcohol Addiction

Mindfulness can be defined as the a very particular mental state which is both wholesome and

capable of clear and penetrating insight into the nature of reality (Cullen, 2011). Where the particular subset of mindfulness, mindfulness meditation originally derived from Buddhist Vipassana meditation is used to teach individuals with physical and mental ailments (Marcus, 2010). The ongoing practice of mindfulness has been shown to lead to significant increases in trait mindfulness which in turn enhance the effects of formal mindfulness practice on psychological symptom reduction (Carmody & Baer, 2008).  The process of combining the mindfulness meditation to address alcohol dependency involves understanding the underlying factors of addiction (Zgierska, 2014). Addiction is principally defined as three main factors, firstly compulsion to seek and take the substance, secondly loss of control in limiting intake and finally the emergence of a negative emotional state (Koob & Volkow, 2010). Alcohol addiction in particular is a prevalent problem in contemporary Australian society where daily 17.4% of adults aged 18 years and over exceed the lifetime risk guideline (Australian Bureau of Statistics, 2015).  This persistent issue that is situated in society brings forth a variety of problems that are placed onto healthcare professionals and alternate intervention methods are necessary (Breslin, 2002).

Differentiating mindfulness meditation from other intervention methods is that individuals are encouraged to self-regulate their own behaviour and control their own impulses (Murphy &  MacKillop, 2011). This essay will evaluate the importance of mindfulness meditation to cope with the multitude of issues that are a direct result of alcohol abuse, each section focussing on one element of the program.

Primarily, through acceptance based rational, mindfulness meditation enhances and individuals ability to cease implus thoughts (Vernig & Orsillo 2009). Where impulses are defined as  external stimuli that directly influence an individual’s action without any conscious deliberation (Strack & Deutsch, 2004). When situated in an environment with alcohol present this stimuli can lead to undesirable response causing a failure in a long term goal such as rehabilitation (Strack & Deutsch, 2004). However when placed into triggering environments mindfulness can donate perspective to an individual’s actions (Sherman, 2017). This involves paying sustained attention to one’s ongoing sensory, cognitive, and emotional experience, without giving in to our natural tendency to react, elaborate, or evaluate (Bishop et al., 2004). The practice includes observing craving, which is considered to be a transient cognitive and affective phenomenon, just like any other experience intending practice is to bring awareness to the experience of craving and to learn to observe it without reacting and judgment (Witkiewitz et al., 2012).

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Additionally, mindfulness aims to shifting from “reacting” to “skillful responding”, arming oneself to be equipped at the situation of anything negative occuring (Bowen et al., 2009). Furthermore, repeated exposure to triggering stimuli during which participants practice nonreactivity may, over time, result in habituation, thereby decreasing the intensity of the initial impulse reaction (Bowen et al., 2009). Concentration on the compulsion of addiction allows the impulsive drives or motivations, substance wanting, emotional states,  physical sensations and stress responses enables an individual to observe their own urges to gain perspective on their own craving (Witkiewitz et al., 2012).

Further research indicates that craving is rooted within the most basic neural processes: positive and negative reinforcement (Brewer, Van Dam & H.Davis, 2015). Such a neural process can create an “addictive loop” through the continual substance use, which has the potential to become a cue-induced unconscious experience leading to a further addiction  (Brewer, Van Dam & H.Davis, 2015). Previous interventions have failed to identify the cues associated with drug use producing more challenges for the treatment of individuals whereas mindfulness has the ability to deal with the omnipresence of cues and to ultimately detect and modify an individual’s relationship with the cue itself (Brewer, Van Dam & H.Davis, 2015).

An alternate proposal stated that conscious craving occurs when the automatic cognitive framework that drives and drives addictive behavior is activated by conditioned, substance related stimuli but then is stopped through situational demands or self-restraint. (Garland et al, 2014) Therefore, the conscious noting of these actions creates an adaptive behaviour to then act as the mediator for maladaptive behaviour.

Secondly, the present notion of mindfulness develops a sense of control within an individual’s mindset to therefore, enabling individuals to continue maintain an attitude of acceptance towards their experience (Bishop et al., 2004). Stemming from the Buddhist tradition, recognising that craving could be targeted by mindfulness meditation, this treatment could also be a possible deterrent for relapse (Witkiewitz et al., 2012). Relapse can be ignited by a variety of sources such as specific environments linked to the intake of alcohol, pre-existing physical and mental health issues and internal guilt from lapsing. But through the introduction of mindfulness these situations can be modified and ultimately an individual’s perception can be altered.  This can be achieved by bringing awareness to the germination of reactions that occur in response to stimuli presents that individuals can alter their own behavioural patterns (Witkiewitz et al., 2012). Shifting views to teach clients to assess their internal reactions to external triggers deescalates the process by not engaging in unconscious decisions that are triggered by these circumstances (Witkiewitz et al., 2012). This process leads to a decrease to a less problematic long-term outcomes and enhances self-motivation within the mindfulness practice (Witkiewitz et al., 2012).

Moreover, these skills of acceptance that mindfulness teaches enhances one’s ability to allow negative thoughts to be present without acting in accordance with them, and to alter these thought patterns to a more positive outlook (Lindsay & Creswell, 2017). This acceptance equips an individual’s ability to combat against the omnipresence of triggers in the environment.

Finally, mindfulness delivers an understanding of the third stage of addiction, viewing the addiction loop process to become more effective than other treatment forms (Brewer, Van Dam & H.Davis, 2015). Mindfulness offers insight into the substantiating factors in regards to the reason an individual consume alcohol, divided into four main categories of motivation to drink includes positive internal enhancement, positive social situation, coping and  external conformity (E. Kuntsche et al., 2005).

To conclude, the multifaceted nature of mindfulness meditation ensures that the stem causes addiction are addressed, ensuring for the continuation of the rehabilitation whilst keeping it within the minds of the individual. Mindfulness based rehabilitation programs address the three main factors of addiction whilst maintaining a treatment option that will ensure longevity with their rehabilitation. Extending meditation therapies can be used to alleviate distress and garner fundamental change in maladaptive behavior and thought patterns (Bowen et al., 2009). For the treatment of alcohol addiction mindfulness training is an essential element to perturb the seeking the substance then to the act as a barrier for the intake of alcohol and finally recognition of  the emergence of a negative emotional state. Mindfulness acts a holistic approach to an alcohol addiction to equip individuals with coping strategies to ensure that relapse does not occur.

















Eric L. Garland, Amelia Roberts-Lewis, Karen Kelley, Christine Tronnier & Adam Hanley (2014) Cognitive and Affective Mechanisms Linking Trait Mindfulness to Craving Among Individuals in Addiction Recovery, Substance Use & Misuse, 49:5, 525-535, DOI: 10.3109/10826084.2014.850309

Peter M. Vernig & Susan M. Orsillo (2009) Psychophysiological and Self-Reported Emotional Responding in Alcohol-Dependent College Students: The Impact of Brief Acceptance/Mindfulness Instruction, Cognitive Behaviour Therapy, 38:3, 174-183, DOI: 10.1080/16506070902767563


Overcoming TV Addiction in Children

“We may think there is willpower involved, but more likely change is due to want power. Wanting the new addiction more than the old one. Wanting the new me, in preference to the person I am now” (thinkexist, 2006). This quote by George Seehan tells us that in order to overcome an addiction we must want to change ourselves first. It is hard for many people to admit that they have an addiction and need help. Overcoming any addiction can be a difficult process, but if one puts their mind to it, anything is possible.

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Defining addictions in general can be difficult. When we think of addiction we usually think of drug or alcohol addictions but there are many types of addictions. Nearly any craving or excess fixation can be categorized as an addiction. “Addiction is a term used to describe a recurring compulsion by an individual to engage is some specific activity, despite harmful consequences to the individual’s health, mental state, or social life” (World Book Encyclopedia, 1966). Many types of addictions have been described such as alcohol, drugs, gambling, food, sex, computers, and work. Adding television to the list should not make a difference considering all the time a person spends watching one.
The viewing of TV is ok, but be careful to not overdo it. “Television Addiction becomes a problem when a subject does not want to watch TV, but experiences an uncontrollable compulsion to start or continue watching” (GNU free documentation, 2008). A person should be in control of the TV, not the other way around. “Television addicts are a relatively new breed, especially since television itself has only been around for about 50 years, nowhere near as long as alcohol, tobacco, and drugs” (Russell, 2008). Even though this may be, television addiction is a big obsession and most people do not even know they are addicted. When a person takes a look at them self and sees how much time and amount of frequency, that they spend on one individual item compared to all activities in a day that is the main focus when figuring out when some type of activity or hobby has become an addiction. It is hard for people to convince themselves that they have a problem and that they should seek guidance. The first and hardest step in recovering from an addiction is recognizing that one needs help.
With the generation that we live in now, it is especially easy to become a TV addict. The new invention of the TiVo, that became public in 1999, is a major contributor to “couch potatoes”. The TiVo stores television programs onto non-removable hard-disks. It also allows the viewer to pause live television, rewind and also replay up to a half hour of recently viewed television. Along with TiVo, where one can record their favorite shows, one can also watch their favorite programs online. On the internet one can find all the local listings to their favorite shows and even watch the re-runs if they may have missed an episode. According to data from the Convergence Consulting Group (1999), nearly a tenth of all broadcast and cable TV shows were viewed online. Convergence (1999) also estimates that 9% of all full-episode TV viewing was done online.
Watching too much television can have negative effects. Reading, school work, playing, exercise, family interaction, and social growth are very important in a person’s life and the time spent watching television takes away from those activities. By spending more time in front of the “tube”, the less time a person will have to spend with friends and loved ones. Too much TV can put a strain on many relationships. A TV addict will find themselves canceling regular get-togethers, just to watch their favorite show. Many will also schedule their lives around a certain TV program. The viewer may not accomplish tasks or goals that he or she feels are important. With some people, a lack of motivation, feelings of depression, and anger comes with the factors of making it a habit of watching television over long periods of time. Many viewers rely on the television because of its’ comforting effects. Trying to go for an extended amount of time without watching can lead to withdrawal symptoms as a person tries to cope with not having the security of the television. Another negative effect is that excessive TV watching inhibits physical activity causing obesity in the Unites States. With the large amount of TV that people watch, there leaves minimal time to do other activities such as work out and stay fit.
Too much television does have its’ negative effects, but if the right TV shows are watched some benefits may appear. TV can be a great educational tool. According to the National Institute on Media and Family (1996), several studies have indicated that quality programming can be educational for young children. A 2001 study shows that “children who watch carefully constructed educational programs that are aimed at their age level do better on pre-reading skills than children who watch occasionally or not at all” (Walsh, 2001). Along with being an educational tool, TV can also bring the family together. Taking time out of the day to spend time with the whole family will help them grow stronger together.
It is easy for children to fall into the category of being a TV addict because their parents do not limit how much they can watch. Children have become lazier than in the past and instead of spending time outdoors with friends playing and exercising, children would rather opt to watch TV shows. According to a recent study done by the Yale Family Television Research and Consultation Center, over the course of the year, children spend more time watching TV than they spend in school or participating in any other activity except sleep (Sather, 2007). Children would be at an advantage if they flipped those roles and watched less television and did more school work and other beneficial activities. Children would rather choose entertainment shows over educational, but in reality children who watch educational shows will do better in their school work. For parents, TV is a simple way to get their kids out of their hair. It is less stressful for parents to have the television entertain their kids rather than for them to have to all day.
TV violence triggers many bad behaviors among young children. Not monitoring what kids watch can bring out these bad behaviors. According to a study backed by the cable television industry (2000) “fifty-seven percent of television programs contain ‘psychologically harmful’ violence. TV violence influences children to act in ways they usually would not. Viewing large amounts of TV violence does not necessary cause a child to act more violently, but it can contribute to promoting a view that violence is routine in everyday life” (Peele, 2007). TV violence not only affects the minds of children, but it encourages them to think that violent behavior is ok.
To overcome any addiction, one must first realize that they have a problem. Correcting an addiction can take a matter or weeks, months, or years. “Overcoming addictions depends on your ability to persevere through difficulties and mistakes, your faith in yourself, your faith in the process, and how much you’re willing to put into the process” (Television Addiction, 2008). If a person does not make an effort then there will be no results. Much like any addiction, it is important to have support from family and friends. The saying, “slow and steady wins the race” is a way of looking at overcoming TV addiction. Start slow by limiting your hours of TV watched. Continue to move forward by taking small steps to achieve your goal.
The recovery process differs from person to person depending on how drastically one is addicted to the television. Overcoming addiction is going to be as difficult as one thinks it is going to be. If a person has the mindset that things are going to be hard then chances are they will be. With more extreme TV watchers, it may be best to get rid of the television set in general. For less severe watchers, it may be as easy as making a TV watching plan for each week. Monitoring how many hours of TV is watched per day is a great step towards minimizing the amount of TV being watched. Other tips to overcome a TV addiction include, only watching when a certain show is on, setting a timer to limit oneself to how long they watch, or throwing out the remote control (Sri, 2008). It is amazing how much less television will be watched when one has to get up every time they want to change the channel. If a timer is used, it is best to place it in another room so the viewer is forced to get up and turn it off. This means that they leave the room where the TV set is, making it a less likely that the viewer will return to watch more television. It is also important to not eat and watch TV at the same time. Doing both can lead to overeating and eventually obesity.
Television viewing for those who are more susceptible to addiction is more like drinking or taking drugs, once you start it is hard to stop. Being aware of the negative effects of too much television will help one not become an addict. Limiting the television intake can increase family time and decrease violence within viewers. Once one decides to turn off the “tube”, the hours that were dedicated to watching TV can now be used for more productive activities throughout the day. By making the step to give up TV, one will be on their way to living a healthier and more fulfilled life.

Relationship Between Consuming Palatable Food and the Risk of Food Addiction in Children and Adolescents


Background: Childhood obesity rates have been rising in the last years as well as publications containing information about the relationship with food addiction. Experts have found a similarity between food addiction and drug addiction, and how it mostly affects children and adolescents.

Objective: To analyze the most recent literature looking for scientific evidence explaining the existing relationship between the consumption of highly palatable foods and how it can lead to addictive food behaviors in children and adolescents.

Methods: Seven articles were selected after conducting a systematic literature review using google scholar and CINAHL. The articles were primary studies conducted in the pediatric population who reported a food addiction behavior using the Yale food addiction scale.

Results: The most relevant and popular finding among the studies was the fact that food addiction symptoms were more present among children and adolescents who had a high BMI and/or were going through a weight loss treatment program.

Conclusions: There is adequate evidence to conclude that highly palatable foods which contain high amounts of fat and sugar can lead to addictive behaviors in children and adolescents. Therefore, there must be more strict and focused intervention from a multidisciplinary team when dealing with a similar situation. More longitudinal and prospective studies should be done in order to confirm these findings and acquire more information about possible long-term adverse effects.


Childhood obesity has become one of the most alarming issues occurring in our society. The center for disease control (CDC) indicates that the prevalence of obesity for children and adolescents aged 2-19 years old is 18.5% and affects about 13.7 million.1 It is undeniable that society and the environment play an essential part in encouraging the overconsumption of highly palatable foods. These kinds of foods may lead children and adolescents to have a tendency towards food addiction. Food addiction symptoms are characterized by loss of control over consumption, continued use despite adverse consequences, and an inability to cut down despite the desire to do so.2

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Food addiction has become a point of attention from contemporary media. The number of publications related to this issue has increased tremendously since 2000.3 The first record of addictive eating behaviors towards food was reported in a scientific journal in 1890 when chocolate was described as food with potential generate these addictive behaviors. Then several years after that the term “chocoholic” became popular. 3,4

The addictive consumption of highly palatable foods is due to their high hedonic properties such smell, taste, and appearance which are processed at the mesolimbic dopamine (DA) reward pathways in the brain, which is the same pathway in charge of the behavioral and neurophysiological effects of addictive drugs.5,6There is a great debate around this issue because unlike known addictive drugs, we cannot live without eating.6 This problem is more relevant to children because kids nowadays have easy access to fast foods, and the industry often targets them from an early age in order to make them dependable of a specific food item their whole life. Children are more vulnerable to food-addictive behavior than adults because, in times of stress, children do not have easy access to any drugs, but to hyperpalatable foods.7 In contrast, adults have easy access to drugs that provide them with pleasure and reward such as tobacco, alcohol, or other drugs. Especially during adolescence, kids will use hyperpalatable foods as comfort foods, which can yield excess calories and eventually may lead them to be obese.

The goal of this literature review is to collect enough research evidence that allows us to analyze if the consumption of highly palatable foods can lead to addictive food behaviors in children and adolescents. Therefore, the research question is:

What is the relationship between consuming palatable food and the risk of food addiction in children and adolescents ages 0 through 21?

In order to complete this summary review, a total of 7 original research articles focusing on food addiction in children and adolescents were reviewed.

Literature Review:

Food addiction and the Yale food addiction scale:

The Yale food addiction scale (YFAS) is a questionnaire composed of 25 multiple choice questions that was developed in 2009 to categorize and identify those who are most likely to be exhibiting markers of substance dependence with the consumption of high fat/high sugar foods. This tool is based on the seven substance dependence criteria in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV. 8 During the questionnaire, participants usually have to focus on the past 12 months when they answer the questions. There is a preselected number of categories from which the participants can choose when answering a specific question. The choices range from ‘never’ to ‘four or more times a week or daily’) and dichotomous scoring (‘yes’ or ‘no’). The Yale Food Addiction Scale for Children (YFAS-C) was recently developed in order to measure food addiction in children due to the rising of childhood obesity. The differences between this new version and the adult one is that the children scale has been redesigned, with appropriate wording and age-appropriate activities, for instance, employment type has been substituted by school, and other categories like parental interactions have been added, many responses have been edited for easier comprehension , and the most important change is that for some question the reading level has been lowered . 8,9

Addictive-like foods:

Our food environment has been in constant change compared to 50 years ago. Food now has a higher level of processing, higher level of additives and preservatives to assure acceptance and shelf life. The industry has become more concerned each day about sales and acceptability of the products by the targeted population, and they will try to add as many food additives as possible in order to increase sales.3 This topic has created a great deal of contradiction and polemic across the scientific community because some people state the fact that there is not such a thing as food addiction since food is necessary for our health and survival.3 However there is enough evidence to state that hyperpalatable foods can be as addictive as drugs. For instance, hyperpalatable foods can activate the dopamine and opioid circuitry inside the brain, which can trigger artificially elevated levels of reward. Many of the foods contain a high amount of sugar or other simple carbohydrates that can be absorbed quickly into the bloodstream, which can alter neurobiological systems. Another similarity with drugs is the fact that these foods are commonly eaten despite harmful consequences and despite a desire to cut down, and they can also induce cue-triggered cravings.3,10

The Reward System :

The brain has a specific region for each of its functions, many addictive drugs have habit-forming action that can be localized in a specific area, and they can activate their corresponding reward circuitry in the brain. The mesolimbic dopamine system or mesolimbic pathway is considered the region that plays an essential role in the progress and maintenance of an addiction.11 The mesolimbic pathway is composed of many dopamine-releasing cells or (dopaminergic ) that send signals from the ventral tegmental area to the ventral striatum. The mesolimbic pathway is the one that enhances motivation and cognition, especially when a specific action would end up in a reward.11 The higher the dopamine levels mean higher gratification or pleasure perception. 12Other structures that form part of the reward system are nucleus accumbens, the septum, the amygdala, and prefrontal cortex. When comparing this with food addiction, it works similarly. Many of these studies of food addictions have been done with rats since we share the same reward system on the brain. It was discovered through these experiments that sweetened water activates midbrain dopamine neurons which then releases dopamine in the ventral striatum. The sweet taste can also activate other brain areas that are usually activated by substances of abuse, for instance, the ventral palladium and the orbitofrontal cortex which is functionally linked to the insular gustatory cortex. 13


A total of 7 articles were selected after conducting a literature search using PubMed, google scholar, and CINAHL. Some of the key terms utilized for the search were food addiction, children, childhood, adolescents, highly palatable foods, obesity, overweight, YFAS, and DSM-IV. The articles were primary studies conducted either with pediatrics population or with the parent or legal guardian of a child. Most of the studies used the YFAS questionnaire, among other significant measures like age, weight, height, ethnicity, and BMI. The publication years of the mentioned studies ranged from 2009-2018.

Pretlow 7conducted a qualitative cross-sectional study among teens and preteens ages 8 to 21. The purpose of this study was to examine why an overweight-intervention open-access website launched in 1999 was not successful in influencing weight loss in adolescents. Data was collected anonymously because adolescents are embarrassed to talk face to face about their weight with peers. Bulletin boards, chat rooms, and multiple-choice pools were used to gather data. Only those whose BMI was higher than or equal 85th percentile were able to post messages in the chat rooms, while the polls did not have any restrictions. A total of 29,406 anonymously unique users posted 41,535 bulletin board messages and 93,787 replies from June 2000 to September 2010. Females participants counted a 94 %, only 5% were male, and for the missing 1%, sex was unknown. The data obtained were analyzed qualitatively for common denominators in weight loss failure and success. The multiple-choice options were quantitatively analyzed. One of the strengths of this study was the use of anonymity, which led to honesty during the responses.

Merlo et al. 9 also conducted a cross-sectional study research with the pediatric population to analyze the factors that may be associated with food addiction during childhood. A total of 50 children and their parent /guardian were recruited from the Pediatric Lipid Clinic at a large southeastern teaching hospital. The ages of the children that participated in the study ranged from 8-19 years old. Children were divided into male and females’ subgroups; they were also categorized by their ethnicity and their BMI was obtained using the Centers for Disease Control (CDC) BMI Calculator for Child and Teen individuals. Their parent/guardian were also divided into male and female subgroups and by ethnicity. Parents also reported marital status and average annual family income. The measures were done by using different assessment created by the authors, among them were Attitudes Test (EAT), Children’s Eating Attitudes Test (ChEAT), Three-Factor Eating Questionnaire (TFEQ), Inventory of Overeating Situations (IOS), Eating Behaviors Questionnaire (EBQ). For the data analysis the following measurements were used: 1) assessment of correlations among parent and child scores for the same variables, 2) evaluation of the association between various eating behaviors and attitudes with BMI ratings for pediatric patients, and 3) exploration of eating behaviors and attitudes associated with self-endorsed symptoms of food addiction among pediatric patients.

In the study done by Meule et al. 14 , the authors aimed to apply YFAS and other questionnaires in a sample of 50 overweight and obese adolescents who were recruited from weight-loss treatment in a rehabilitation hospital in Germany. Patients were approached individually, and they were asked to answer a variety of questionnaire. The YFAS is composed of different scoring options to indicate the experience of addictive eating behavior within the past 12 months. Another measure was the Food Cravings Questionnaire (it measures the frequency and intensity of food craving experiences). An Eating Disorder Examination Questionnaire was also one of the measures that analyzed eating disorder psychopathology. The Barratt Impulsiveness Scale was a short form that was used to measure trait impulsivity on a four-point scale ranging from rarely/never to almost always/always. For the last measure, they used the Center for Epidemiologic Studies Depression Scale, which measures depressive symptoms within the past week.

Schulte et al. 2 utilized a cross-sectional design in order to identify which foods were most likely to be consumed in an addictive way. The authors conducted two studies:

In study one, 120 participants were recruited from the University of Michigan either through flyers or through an introductory psychology subject pool. Participants were aged 18 to 23 years old. Participants had to complete YFAS questionnaires. To complete the questions, the participants were asked to think about foods high in fat or refined carbohydrates when they read the phrase “certain foods”, in the questions. Then the participants were presented with two pictures at once from a 35-picture bank, and they were asked to select which one they had trouble with. In the end, the participants reported demographic information and ethnicity, gender and weight, and height were taken.

In study 2: A total of 398 participants were selected through Amazon’s Mechanical Turk (MTurk). Each participant was compensated $ 0.40 for their time. The authors decided to follow a strict set of inclusion criteria; for instance, the weight had to be less than 900 lbs. , they had to be between 18 to 64 years old, they needed to provide their gender and answer correctly to specific catch questions that identified if the individuals were answering questions without correctly reading. Participants completed the same version of the YFAS. Then rather than comparing each food against another to identify the one that caused more trouble like in study one; participants were asked to rate how likely they were to experience problems with each of the 35 foods in the bank. Participants also reported demographic information, ethnicity, gender, as well as weight and height.

Burrows et al.15 conducted a cross-sectional survey to analyze and understand the factors associated with addictive eating behaviors in children as reported by their parents. The participants for this study were parents or principal caregivers of 5 to 12-year-old children recruited through Amazon Turks. A total of 163 parents/ primary caregivers currently residing in the U.S. and each of them were paid $0.50 for completing the survey. The survey consisted of 146 questions that asked the parents and caregivers to report demographics, addictive eating behaviors and parental feeding practices about themselves and demographics and addictive eating behaviors; dietary intake and demographics about their children. Food addiction scores for parents were determined using the adult version of the YFAS. Parent’s feeding practices were assessed using the Child Feeding Questionnaire (CFQ). Chi-square, t-tests, and ANOVAs were applied to investigate the differences in frequency of food addiction symptoms, food addiction diagnosis and the relationship with demographic variables, feeding practices and the weight status of both children and parents.

In another cross-sectional design study done by Falbe et al. 16 they tried to examine the potentially addictive properties of sugar-sweetened beverages (SSBs) in the overweight and obese adolescent population. A total of 25 participants between the ages of 13-18 years old with a BMI of≥85 percentile for age and sex. In order to be included in the study, the participants had to speak English and have a parent or guardian who spoke English or Spanish. Adolescents were excluded from the study if they were either pregnant, nursing or undergoing mental health treatment. During Phase 1 of the study, participants were instructed to continue drinking their usual beverages for 5 days. Then for phase 2 the cessation period they were allowed only to drink plain water or plain milk. Participants were reimbursed for traveling, and they received $160 for their participation. The measures during the study were primary for the symptoms of withdrawal and craving with a scale that recorded mood change, behavior, and physical symptoms. The authors focused on withdrawal because it maintains the continued use of a substance to alleviate symptoms, and cravings predict the frequency of substance use and relapse. Many of these symptoms occur in response to cessation from high sugar intake evidenced by animal model. The withdrawal scale was assessed with Cronbach’s alpha.

Rocha Filgueiras et al. 4 this article is a cross-sectional study done in the city of Sao Paulo, Brazil. A total of 139 children from both sex and ages 9 to 11 that were enrolled in a low-income school were included. Parents/guardian had to provide written consent for their children’s participation in the study. The inclusion criteria in the study were the presence of excessive body weight. The exclusion criteria were the presence of any cognitive or physical delay, taking medication, which, the apparent side effect was body weight management and those with a family issue that could affect compliance with the study. Some of the measures used were the ale Food Addiction Scale for Children (YFAS-C). A dietary assessment was used using the semi-quantitative food frequency questionnaire. Quantification and classification of foods in which data on food intake was converted to energy and nutrient data. Pubertal staging, as well as socioeconomic status, were measured, the authors also measured anthropometrics and blood samples were used for biochemical analyses.

See TABLE 1 for summary of results.

TABLE 1: Summary of results from collected literature



Pretlow et al. 7

54% of respondents (n = 52) stated that they usually do mindless eating when they were stressed or bored.

 Many of the posts exhibited at least 3 criteria that meet DSM-IV substance dependence (addiction) criteria by the American Psychiatric Association (1994):

a) large amounts of substance consumed over a long period, b) unsuccessful efforts to cut down, and c) continued use despite adverse consequences.

As classical with drugs, it was found that 77% of respondents (n = 92) indicated they ate more now than when they first became overweight.

Merlo et al. 9

 The BMI ratings of the kids were significantly correlated with overeating (r = .42, p = .02) and emotional eating (r = .33, p = .04).

 The children’s total scores on the ChEAT were significantly related to the parents’ scores on the EAT (r = .39, p = .009).

Food addiction symptoms were significantly correlated with child overeating (r = .64, p r = .60, p r = .62, p r= .58, p r = .54, p r = −.31, p = .04).

Meule et al. 14

 Most common food addiction symptom was a persistent desire or repeated unsuccessful attempts to cut down consumption.

Adolescents with a YFAS diagnosis had higher eating, weight and shape concerns.

They also reported more days with binge eating incidents and food craving experiences.

The also had more symptoms of depression and scored higher on attentional and motor impulsivity than individuals without a YFAS diagnosis.

Schulte et al. 2

For study one:


Food with a high level of processed or added amounts of fat and/or refined carbohydrates (chocolate, pizza, cake) appeared to be associated with problematic addictive-like eating behaviors.

For study two:


Consistent with study one, highly processed foods, or foods with added quantities of fat and/or refined carbohydrates had greatest association with addictive-like eating behavior.

 BMI and YFAS symptom count were small to moderate positive forecasters for this association.

Fat and Glycemic Load were significant positive predictors of problematic food ratings.



Burrows et al. 15

In children, food addiction was significantly associated with higher child BMI z-scores.

Kids with higher food addiction symptoms had parents with higher food addiction scores.

The parents of food addictive children reported higher levels of pressure and restriction to eat feeding practices, but not monitoring

YFAS-C scores may be at larger risk for eating-related issues in children.

The YFAS-C score is at risk or the person?

Falbe et al. 201816

During cessation of sugar-sweetened beverages, adolescents, reported an increased craving for those drinks.

Adolescent experienced headaches and impaired ability to concentrate.

During cessation, participants reported lower total daily consumption of sugar (−80 g) and added sugar (−16 g) (Ps

Rocha Filgueiras et al. 4

From the 139 children, 24% had a diagnosis for food addiction.

The “food addictive-group” displayed, on average, 14 grams higher intake of added sugar per day than the non-food-addicted group.

The eating of cookies/biscuits (OR=4.19, p=0.015) and sausages (OR=11.77, p=0.029) were independently associated with food addiction.

The intake of added sugar was also positively correlated (r=0.27, p=0.001) with constant use of the substance despite the knowledge that it was causing or leading to a physical or psychological problem.



First, it is important to summarize addiction-related behaviors related to drugs (for example craving, withdrawal) also found when consuming HP foods. From the results presented by Schulte et al.2 they showed that highly processed foods with a high amount of fat, sugar, and white flour were reliable indicators of food addiction. These ingredients are usually what makes a food item to be highly palatable. These results were congruent with the results obtained by Rocha Filgueiras et al. 4 , which pointed out that cookies/biscuits and sausages were the most problematic addictive foods. Schulte et al. 2 results also support this, because they found that the amount of Fat and the Glycemic Load of the food item were significant positive predictors of problematic food ratings. Falbe et al.16 found that children experienced withdrawal symptoms such as headaches and impaired once they stopped the consumption of sugar-sweetened beverages. These are the same symptoms present when an individual is going through a drug withdrawal.

The second aspect to focus to answer the research question is the association between the feeling of negative emotions and the consumption of highly palatable foods. The results found by Rocha Filgueiras et al. 4 show that the continued intake of added sugar correlated to the uncontrolled overuse of the substance, even though that it was causing or leading to a physical or psychological problem. Pretlow et al. 7 also found that participants stated with their own words they felt bad and unhappy with their body image, and still could not control the desire for eating. Rocha Filgueiras et al. 4 also pointed out that children who met the criteria for food addiction also consumed more sugar on average that the children who did not meet the criteria. This is problematic because if highly palatable foods are effective to relief negative emotions, children can develop patterns of dependency on these foods.

Another interesting finding was according to A. Meule et al. 14 and Merlo et al. 9, children eating attitudes test significantly correlated to their parents. This led us to the conclusion that there is a parental influence when it comes to eating patterns and that children may adopt a similar eating pattern as their parents.

Finally, it is essential to mention the evidence that shows how negative physical characteristics are related to feeling addictive patterns regarding food. From the seven articles reviewed, Merlo et al. 9 and Burrows et al. 15 independently concluded that food addiction symptoms might be more prominent in children and adolescents who are obese or overweight as well as in adolescents who are currently seeking weight reduction treatment. Meule et al. 14 also found a similar result with adolescents with an addiction diagnosis based on YFAS. They had higher eating, weight, and shape concerns and reported higher depression symptom when compared to adolescents who did not had a YFAS diagnosis of addiction.


It has been demonstrated that childhood obesity has become a prominent issue in our society. After reviewing and discussing the results from the above-selected articles, it was found that there is enough evidence to say that the consumption of highly palatable foods could lead to food addiction. These food addictions symptoms are more evident if the child is either overweight/obese or trying to lose weight or going through permanent or temporary stressful situations. However, it is a complicated health condition to tackle because it is dependent on both social and environmental conditions specific to every child and as well the diet that the individual consumes.

Very little is known, both by society and professionals, about the topic of food addiction in kids and adolescents. This lack of knowledge prevents the successful creation of programs to help eradicate childhood obesity. There must be more emphasis from the health working force (doctors, nurses, dietitians, and behavioral health) placed into food addiction and how to help children control it. Additionally, all the articles reviewed highlighted the lack of recommendations as to what to do to tackle or decrease food addiction symptoms or how to decrease stressful situations in order to avoid the upcoming symptoms. Therefore, to eradicate food addiction the scientific community needs to place the significant findings more accessible to the affected population, and they need to give them the necessary tools to confront the issue otherwise this addiction will keep growing unstoppable. More prospective and longitudinal studies have to be done in order to acquire and confirm these findings and to know what other possible long-term adverse effects of this addiction in children are.



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