If we retrace this brief overview of addiction-related conditions, I previously explained how not only substances can trigger the reward circuits, but also certain behaviors. I also mentioned that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes only one type of non-substance-related disorder, namely Gambling Disorder.
In the previous posts, we looked at some introductory concepts for Substance-Related Disorders, namely: the reward circuit and addiction. The clinical framework of these disorders is complex but also repetitive. I say this because the criteria used to diagnose, for example, an alcohol use disorder or a cannabis use disorder are quite similar—the main differences lie in the physical symptoms that develop in cases of intoxication and withdrawal from one substance versus another.
In the previous post, I introduced the concept of addiction, simplifying it like this: the substances that can cause addiction have in common the activation of the reward circuit. Before moving into the clinical aspects, I think it’s useful to first familiarize ourselves with some important terms: tolerance, intoxication, withdrawal, and craving.
What does it mean to be addicted to a substance? When we talk about addiction, we usually think of drugs. However, “drug” is not a strictly scientific term—it belongs more to social, and probably legal, vocabulary. It defines a group of substances that are capable of causing addiction or whose possession and distribution are prohibited by law. But how do we approach the issue from a clinical perspective? Let me explain it in my own words.
The journey through Disruptive, Impulse-Control, and Conduct Disorders concludes with the following two disorders: Pyromania and Kleptomania. These are probably words we already know, but let’s go over them again.
In the previous post, we saw how the angry outbursts of Intermittent Explosive Disorder can even culminate in physical aggression. The next step is the inability to control behavior, which may lead to harming others (through aggression, theft, or property destruction) with a possible lack of concern for the consequences of one’s actions. This is the case of Conduct Disorder.
When I talked about emotions, I explained the concept of the priority of negative emotions. This is an evolutionary concept, according to which negative emotions such as anger and fear are activated more quickly than others because they are adaptive. In other words, recognizing anger in others and in oneself helps avoid a potentially harmful escalation.
In the previous post, I introduced Disruptive, Impulse-Control, and Conduct Disorders. I described them as disorders involving difficulties in self-regulation of both behaviors (that violate the rights of others and social norms) and emotions (such as anger).
The world we live in is a social world, made up of social norms but also laws that must be respected. Learning to control our behavior in order to live peacefully within society is an important skill to acquire. Resolving disputes by attacking others, taking possession of goods through theft, or releasing anger by destroying things are behaviors that distance us from the social context and could lead to the restriction of personal freedom. Behaviors that violate the rights of others and contradict social norms fall under the category of Disruptive, Impulse-Control, and Conduct Disorders.
When talking about gender identity, we saw how the gender assigned at birth may not align with an individual’s perceived gender.
Sometimes, this lack of correspondence can lead to psychological distress, and in this case, we talk about gender-related dysphoria.
