Understanding Addiction to Harmful Online Content

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) provides a comprehensive framework for understanding mental health conditions, including addictions. Substance use disorders (SUDs) are patterns of symptoms resulting from the use of various substances. Let’s delve into the key aspects.

1. Substance-Use vs. Substance-Induced Disorders

  • Substance-Use Disorders: These patterns of symptoms arise from continued substance use despite experiencing problems. The criteria necessary for diagnosis are based on:

    • Impaired control: Taking the substance in larger amounts or for longer than intended.
    • Social impairment: Spending excessive time getting, using, or recovering from substance use.
    • Risky use: Engaging in substance-related behaviours that put the individual at risk.
    • Pharmacological necessity: Developing tolerance (needing more of the substance for the desired effect) and experiencing withdrawal symptoms when not using the substance.

  • Substance-Induced Disorders: These include intoxication, withdrawal, and other substance/medication-induced mental disorders. They result directly from the effects of substances.

2. Recognizing Substance-Related Disorders

The DSM-5-TR identifies substance-related disorders related to the use of 10 separate classes of drugs.

Alcohol

Caffeine

Cannabis

Hallucinogens

Inhalants

Opioids

Sedatives


Tobacco

Hypnotics (anxiolytics)

Stimulants (including amphetamine-type substances, cocaine, and other stimulants)

Additionally, the use of other or unknown substances can also contribute to substance-related or addictive disorders. The activation of the brain’s reward system plays a central role in problems arising from drug use. The intense rewarding feeling associated with drugs may lead individuals to prioritise drug use over other normal activities.

 

3. DSM-5-TR Substance Use Disorder Criteria

Substance use disorders encompass a wide range of issues related to substance use. The DSM-5-TR outlines 11 criteria for diagnosing substance use disorders:

  1. Taking the substance in larger amounts or for longer than intended.
  2. Wanting to cut down or stop using the substance but failing to do so.
  3. Spending a significant amount of time obtaining, using, or recovering from substance use.
  4. Craving or experiencing intense urges to use the substance.
  5. Developing tolerance (requiring more of the substance for the same effect).
  6. Experiencing withdrawal symptoms when not using the substance.
  7. Using the substance despite physical or psychological problems caused by its use.
  8. Giving up important social, occupational, or recreational activities due to substance use.
  9. Using the substance in situations where it’s physically hazardous.
  10. Continuing to use the substance despite knowing it causes problems.
  11. Needing more of the substance to achieve the desired effect.

Addiction to Online Sexual Content

Addiction to online sexual content is a form of compulsive sexual behaviour, which is sometimes considered as a behavioural addiction or an impulse control disorder. The below model, explores this in more detail.

 

Intoxicating
Users of online sexual content often report a drug like euphoria while preparing to or engaging in sexual activity on the internet. It is this ‘rush’ that lures people back after they have given up the behaviour. What makes it intoxicating?

  • Easy and immediate access to whatever kind of sexual experiences, information, pictures and video material.
  • An opportunity to develop sexual fantasies and objectify others without fear of rejection.
  • The chance to specify your ideal partner (s) and preferred sexual activities.
  • The chance to become part of the fantasy without responsibility or consequences.
  • The chance to learn about or experiment with new or previously unknown sexual behaviours. 

Isolating
What is your own experience of the isolating characteristic of internet use?

  • Allows you to engage in intoxicating experiences quickly and privately.
  • Nobody needs to know.
  • It can seem victimless and harmless.
  • Time spent on the internet distances the user from their partner, family and friends.
  • Real-life friends and family do not share the virtual world with the user.

Irresponsible

  • The internet is part of most people’s personal and work lives. It’s available all the time.
  • The ability to distance self from the abuse and lack of consequences promotes irresponsible behaviour.

Imposing

  • It’s hard to avoid the internet even if you want to – work and other agencies may demand we use it.
  • The internet offers a formidable choice of content.
  • It’s easy to spend hours – longer than you intend – surfing the internet, researching, or attempting to access something.

Interactive

  • You can interact with others verbally or visually or both.
  • You can join a likeminded virtual community.
  • You can interact in real time.
  • You can find reinforcement from others for illegal or socially disparaged interests and beliefs.
  • You can arrange to meet in the real world.
  • You can contact people around the world.

Inexpensive

  • Cheaper than buying pornography in the form of magazines, videos or online.
  • Pop-ups let you select what you want to view and purchase only that.
  • Cheaper than using prostitutes, strip clubs, etc. and more anonymous.
  • Less messy, complicated or risky than real life sexual engagement. 

Exercise

Do you consider yourself to be addicted to online sexual content or activity? Do you consider yourself to be at risk of developing an addiction to online sexual content or activity?


Considering the above model, reflect on the various factors that maybe contributing to this.