Addictive eating disorders

Addictive eating disorders have been a part of history and have only recently been recognized as psychiatric disorders. Increased publicity has enabled family and friends of eating disordered individuals to recognize the disease and seek help for them from trained medical professionals. Everyone is "at risk," but certain subpopulations have been "coming out of the closet" in epidemic proportions. An ever-increasing number of high school-aged and college-aged females have developed some form of eating disorder, from fad diets to self-induced vomiting. In these individuals, the obsession with thinness takes priority over family, friends, schoolwork, or career. Strangely enough, the eating disordered person's addiction is not to food but to the feeling of numbness her behavior brings. Over time, the need to control is desperately sought and many patients transfer their obsession to other patterns of self-abuse. Nursing intervention should include setting the appropriate example in terms of the professional's relationship with food, while providing much needed emotional support. An innovative method of intervention available to nursing professionals includes the use of creative, visual imagery to repeatedly diffuse fear and anxiety about food until a level of personal autonomy over the disorder and other emotional concerns is achieved. Therefore, a system of recovery can be designed for the anorectic or bulimic patient and the experience of recovery from the eating disorder can be a lifelong process of personal growth.     

Perspectives: Addictive Sexual Behavior

A rationale for the conceptualization of repetitive sexual behaviors as an addiction is presented. Five cases treated by individual psychotherapy are described and certain problems inherent in such treatments are delineated. Other treatment approaches, such as those involving the use of medication, twelve-step groups, and cognitive-behavioral techniques are also detailed.     

Application of Neuro-Linguistic Programming to Addictive Behaviours: Part II

Neuro-Linguistic Programming (NLP) is a rapidly and intricately evolving field of study and practice. Therapeutic ambience, principles and techniques deriving from this approach to psychotherapy are outlined and proposed to exhibit significant potential in the treatment of addictive behaviours. Although empirical research is at an early stage, and some exaggerated claims are probably being made by NLPers, a substantial body of clinical evidence is accumulating to support the value of NLP in the facilitation of a person's freedom from the tyranny of addictive behaviours.     

In Search of How People Change: Applications to Addictive Behaviors

How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key transtheoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages—precontemplation, contemplation, preparation, action, and maintenance—and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a transtheoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.     

Research Update: Addictive Patterns Among Battered Women: A Pilot Study

Drug and alcohol use figures as a prominent factor in many situations of domestic violence. Patterns of misuse or abuse of these substances may signal addictive behaviors. Consequences of the addictive use of drugs and alcohol by battered women may impair the decision-making process, limiting the possible alternatives to leaving a violent home. Other women may remain in the situation because of addiction to the relationship. Information collected on the potential addictive behaviors of battered women can help determine areas of assessment and intervention. Assessment in this area can prevent severe consequences of all addictions: drugs, alcohol, nicotine, and food. While knowledge on relationship to addiction is minimal, information in this area may help to explain women's selection of mates or need to stay in a destructive relationship that sometimes results in death at the hands of her mate. Currently proposed research will explore addictive behaviors among 100 women. Women of various ages and ethnic groups will be questioned regarding general demographic material, past and current relationships, violent behavior of spouse or child, abuse of drugs, alcohol, food, and nicotine. Subjects will be temporarily housed at either a local woman's shelter for abuse, an eating disorder unit, or a private psychiatric facility for chemical dependency. Additional women in outpatient therapy for an eating disorder with a private counselor also will be surveyed. A control group of females (n = 50) not identified as victims of violence or having addictions to drugs, alcohol, food, or nicotine will be similarly surveyed. Data related to addictive behaviors will be collected via the PROMIS Questionnaire, a series of 30 similar questions identifying information on 12 different addictive areas. For this research study information will be collected on five addictive areas only. Collective data on each subject will be plotted on a specific circular graph highlighting both primary and possible cross addictions. History of relationship of violence will be assessed via the Conflict Tactic Scales (CT Scales). Demographic information will be gleaned from participants' answers to several short questions. Study results anticipate that battered women will present with a primary relationship addiction and several potential cross addictions as they battle to survive the violence of which they are a part. Information collected will serve to help others better understand the needs and coping strategies of battered women and explore why some battered women choose to stay in abusive relationships.     

Addictive behaviors related to opioid use for chronic pain: A population-based study

The growing body of research showing increased opioid use in patients with chronic pain coupled with concerns regarding addiction encouraged the development of this population-based study. The goal of the study was to investigate the co-occurrence of indicators of addictive behaviors in patients with chronic non-cancer pain in long-term opioid treatment. The study combined data from the individual-based Danish Health Survey in 2010 and the official Danish health and socio-economic, individual-based registers. From a simple random sample of 25,000 adults (16 years or older) living in Denmark, 13,281 individuals were analyzed through multiple logistic regression analyses to assess the association between chronic pain (lasting ?6 months), opioid use, health behavior, and body mass index. Six potential addictive behaviors were identified: daily smoking; high alcohol intake; illicit drug use in the past year; obesity; long-term use of benzodiazepines; and long-term use of benzodiazepine-related drugs. At least 2 of the 6 addictive behaviors were observed in 22.6% of the long-term opioid users with chronic pain compared with 11.5% of the non-opioid users with chronic pain and 8.9% of the individuals without chronic pain. Thus, a strong association was demonstrated between long-term opioid use and the clustering of addictive behaviors. An intricate relationship between chronic pain, opioid use, and addictive behaviors was observed in this study, which deserves both clinical attention and further research.     

Cocaine Analog Coupled to Disrupted Adenovirus: A Vaccine Strategy to Evoke High-titer Immunity Against Addictive Drugs

Based on the concept that anticocaine antibodies could prevent inhaled cocaine from reaching its target receptors in the brain, an effective anticocaine vaccine could help reverse cocaine addiction. Leveraging the knowledge that E1⁻E3⁻ adenovirus (Ad) gene transfer vectors are potent immunogens, we have developed a novel vaccine platform for addictive drugs by covalently linking a cocaine analog to the capsid proteins of noninfectious, disrupted Ad vector. The Ad-based anticocaine vaccine evokes high-titer anticocaine antibodies in mice sufficient to completely reverse, on a persistent basis, the hyperlocomotor activity induced by intravenous administration of cocaine.