The Journal of Behavioral Addictions recently published a study from researchers at Baylor University and Seton Hall University. The result include observations that cellphone obsessions, including high volume instant messaging and texting may be like shopping addiction, with aspects of materialism and impulsiveness that show signs of becoming an addiction. In another recent study, Americans check their phones once an hour — at least— and nearly three out of four respondents said that losing their phone would make them feel “panicked.” The fear of being out of contact with someone via mobile phone is called “nomophobia.” A TIME magazine poll released earlier this year of people around the world showed that 84 percent of people don’t think they could be separated from their phones for just one day. We discuss the issue and ways it will be treated in the new DSM-5.
Transcript (edited):
HOWARD: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions, I am Howard La Mere. Behavioral issues are kind of in the news and that’s one of the things I want to start out talking about. We’re going to drag some other stories into the mix, but new story about research coming out of Baylor University and Seton Hall University finding a connection between cell phone addiction use and materialism and impulsiveness as what might lie behind that. And that’s just published recently in the Journal of Behavioral Addictions. It said across the world in a recent survey 84% of people interviewed across the world, everywhere felt that it would be very uncomfortable, very difficult for them to be separated from their cell phone for a day. And that is a pretty amazing statistic, I think. So, Darryl that’s what I want to start out with talking about and how that relates to drug addiction and the behavioral addictions that we have been talking about, be it eating addiction, shopping addiction, which of course is topical this time of year, and sex addiction, which has been in the news a lot the last year or two, and the other behavioral addictions that are appearing in the new DSM Diagnostic and Standards Diagnostic Statistic Manual which is due out in 2013 .
DARRYL: Yes, Howard, gambling is for sure going to be included in DSM-5 coming out in May of 2013. We know that they have decided to table the decision to include internet or computer addiction, but there is serious thought that because of recent research that sexual addiction will probably be covered and probably be a part of the DSM-5 although that is not for sure.
HOWARD: Is there a broad category of behavioral addiction?
DARRYL: No. What the DSM-5 is doing with addictions is change it to “addictions and related disorders” and then identify specific substances and categorize the intensity of compulsivity. Gambling will be part of addictions and related disorders. They may include other behaviorals as well and group them as addictions and related disorders not otherwise specified, n.o.s. That is a big catch all category. But I think this research from Baylor is kind of fascinating. They quote that statistic you mentioned – that 84% of the people surveyed worldwide who use cell phones say they don’t think they can be without their cell phone for 1 day – that’s just phenomenal – especially for people our age, Howard, we remember when there were no cell phones – how did this happen so quickly. It seems like overnight.
HOWARD: It does seem like it’s overnight.
DARRYL: The study itself, as quoted in the Huffington Post was conducted on college students and the sample was small. I think they queried close to 200 college students, but I thought it was fascinating that 3 out of 4 or 75% of students with cell phones said that if they had to go a day without their cell phones, they believe they would have a panic attack. I’m not sure what that means. What is this saying about the mental status or the health status of people who are so reliant on their cell phones is it just pure addiction, which it might be and therefore includable in the DSM-5 – or is it merely a feeling that you’re important enough that you have to have a cell phone so that people can be in touch. Is it an insecurity thing? Is it a paranoid thing that without a cell phone you won’t be able to reach someone who is very important to you or you will be unable to get help if you need it? It speaks a lot about what’s happening to the psyche – to our society and how we’ve come to rely on this technology and how we can’t do without it because it’s addressing so many underlying fears and phobias and needs. It’s phenomenal and maybe as the whole addiction category broadens we maybe have to look at all these things. Before we were comfortable in saying that 30% of the U.S. population was vulnerable to addiction. Dr. Kevin McCauley expanded that to 40%, I think because he includes gambling and other disorders. When we start including all of these, we may be seeing that the majority of people in the United States have a propensity to one form of addiction or another. The holidays are a time when people shop alot and we could conclude that there is a shopping disorder or dysfunction, but that would be not correct. We’re talking about only a small percentage of the U.S. population having any of these specific disorders. When we talk about compulsive gamblingwe’re talking about maybe, at the most about 5% and pathological gambling, 6%. When we talk about shopping – the actual disorder is buying. You know, if you shop like my wife shopsdrags me out all day long and looks at things and doesn’t spend a dime that’s not a real disorder. It’s not impacting us in a negative way you may think wasting your whole day, going out shopping is a negative disorder, but I can’t really see that. I like to go to football games which could be considered the waste of my whole day but people need to have their brain distracted from time to time. The real disorder is involves buying things you absolutely don’t need. And you buy to the point of creating negative consequenceslike being deep in debt. I think that only affects a small part of the population. Shopping for gifts is a different thing – you are considering others, you have a list. A person with a buying disorder does not have a list – they are impulsive.
Brain scans show some behaviors trigger a reward mechanism. Behaviors or disorders can cause inappropriate hyperactivity or maybe even an under activity of the reward center in your brain. It starts out as hyperactive. Again, I hate that word reward because all of this takes place in the unconscious area of the brain so it’s really a survival mechanism and then as a person participates in these behaviors or uses drugs, there is a depletion of dopamine which causes under activity resulting in an inability to get that reward or feeling or satisfaction. It is survival driven and makes people compulsive and obsessed to keep doing what ever it is. And cell phones assist in that – people can connect for sex, to gamble, to shop, and everything in between.
The other area of the brain that is currently being studied is the control area of the brain. New studies come out every week one mentioned that it’s the orbital frontal cortex – more specifically it’s linked to one part of the orbital prefrontal cortexleft ventral medial prefrontal cortex, the control mechanism that creates the first reaction to an impulse experienced by dysfunctional people with these disorders – they succumb to that impulse without any ability to control it. That seems to be a commonality between people who have these varieties of addiction and related disorders – a hyperactivity of their reward mechanism, which we call the stop switch or the survival reinforcement centers of the brain. Studies show that individuals with a cocaine addiction or an opiate addiction or a marijuana addiction or any other addiction or behavior compulsion usually have those 2 components out of whack.
HOWARD: A couple things come to mind. I’ve known a few people that have the shopping bug and the dedicated cable TV channels for shopping certainly plays into that and are watched by a lot of people with this condition. When it comes to cell phone use and internet use, people using smart phones take a lot of pictures, make movies, and then share them on You Tube and places like that but I was also thinking about the role that the cell phone played in the Arab Spring and how that was critical. So, what I’m getting at here is maybe there’s a component of this obsession that has to do with the need and I think this is a very basic needthe need for us to be more tied together as a peopleas humans in the context of these very confusing times.
DARRYL: Well, you know, it’s interesting you bring that up, Howard, because themost recent Journal of Discover Magazine came out with an article on cooperation and altruism. I did some work with Dr. Lynn O’Connor who believes strongly that altruism is hard-wired into the human consciousnessit’s part of our genetic make-up and it’s part of the way our brain operates.
HOWARD: And there have been some interesting experiments in that too, right?
DARRYL: Oh, there are fascinating experiments involving little kids who have just learned to stand and walk. An adult drops something and every little kid who sees it kind of struggles to get up and pick up the thing and bring it over. A real sign of altruism. These kids can’t speak yet, they can barely walk, but they’re trying to be helpful to another human being. The article is interesting because this is a scientist who has dedicated his whole career to studying this and he sees it as an evolutionary Darwinian characteristic in terms of survival and adaptation. He believes that human beings developed this need to be part of a community and to work together because that ensured better survival, even though it might undermine the individual survival of oneit was better for the survival of all and overall that won out.
There is an interesting dilemma created by this – and a lot of research has been done on what is called the prisoner’s dilemma. Two perpetuators of one crime are approached separately by the police and are told that if they rat on their fellow criminal they will do less time – say only 1 year in prison instead of 3. The dilemma is that if the person gives up his friend or cooperates, then he will get only 1 year instead of 3 years, but if both of them shut up and stick together, they’ll both do 2 years instead of 3. In a way that sort of validates people’s need for cooperation and working together – maybe the way you see it, maybe that’s a cell phone. Maybe the cell phone is clicking us all together and bringing us all together as one force. I can envision the concept as a new development of a mega brain. Just the coordination of people communicating and sharing images and creating a way for society to move as a whole rather than as an individual and I think that might be another way of viewing this. Or, it might simply be addiction. It could be anti-survival or definitely objectionable to all your friends and family – people sit at the dinner table never looking up from it – somebody mentions some obscure fact and you’re on it for the next 10 minutes trying to look it up on the internet. I mean, I’ve seen that done a lot and it really speaks to some sort of disorder or dysfunction within our society. Remember when virtual reality was the big thing – one of the creators was asked what’s going to happen to real reality with this? She said, Reality? That’s passe. It doesn’t mean anything. And that’s maybe where the cell phone thing is going – substituting actually being with your friends with connecting with them on Facebook, twitter and the like – maybe it is the new reality.
HOWARD: I go back and forth with people about this. I thought this was an interesting topic that deserved a little talking about. Do we have anything else to share with folks this week?
DARRYL: Well, one behavioral disorders that is getting more attention in terms of linking the reward system of the brain and brain chemistry is eating disorders, especially compulsive overeating and binge eating disorders. More and more brain imaging studies are showing that craving and the results of binge eating and compulsive overeating replicate what happens with drug addictions in the rewards center and also in the impulse control center. Because of that I believe eating disorders should become a part of addiction related disorder, although I have been told that the DSM-5, is going to continue to consider it as its own specific disorder. Eating disorders will be separate from addiction and related disorders, even though the brain imaging confirms that it is very much like an addiction and related disorder. One other thing I noticed on the news that I found interesting, Howard, just because it’s asked of me so many times when I work with clients or give a presentation or have an audience of people who are addicted or recovering, is – why do people have a specific drug of choice? How can someone love cocaine, but very much dislike Vicodin or Oxycontin or heroin. Why do some who abuse alcohol look down upon people who are methamphetamine addicts? We know that genetics plays a huge role in terms of different genes that line a person up to react to different drugs that that tends to determine a person’s drug of choice. New electroencephalogram (EEG) findings track late positive potential which responds to either something that is a brain frequency or brain wave that illustrates how a person responds to something either in a positive way or a negative way. Using pictorial images of drugs or different drug scenes EEG technology can predict what drug of choice people will be addicted to by how their brain responds to those images or certain triggers about those drugs. I find that interesting and maybe something that we might be able to use in treatment to do the propereither nutritional, pharmacological, or clinical interventions that specifically address what a person’s drug of choice potential is.
HOWARD: So, I can see that kind of being a color coded message that shows up in your brain scan.
DARRYL: Well, you know, I can see that too, Howard, because I think now each drug of addiction creates a specific kind of EEG effect in your brain and I’ve heard they’ve got these little bands they can just put over your forehead that respond to frequencies and can instantly what drug you’re under without doing a urine test.
HOWARD: Well now that’s interesting.
DARRYL: There is one other story – just because you asked – was actually in a journal of economics a journal of investing where an investment advisor looks at different pharmaceutical firms who are developing treatments, medical treatments, or pharmaceutical treatments aimed at major drug addiction. The article presents the economic profile of the big pharma companies that are doing that and actually gives the reader advicehey, this is something to invest in. This is something that looks like it’s going to be making a great big profit for these industries. And to hear that is sort of a positive and negative. It is all about money.
HOWARD: It is about money, yep!
DARRYL: In a way it’s not very good because there is bound to be exploitation all along the way. But on the other side of the coin – it is a total validation of everything we’ve said for yearsthat addiction is a true biomedical condition and that the more awareness of the condition will result in big pharmaceutical companies looking at the solutions as an investment rather than dismissing addiction as something that’sthat is criminal. So, I think there are big changes happening here.
HOWARD: And the overall slow but sure change from our perception of what it means to be addicted and how people got to that place. Well, we’ve been all over the map here today and I find it kind of quite interesting and I hope those of you listening did also. We’ll wrap it up for now. We do thank you for listening. Questions, comments, and suggestions are always welcome and you can do that at the website, cnsproductions.com.
Darryl, thanks.
DARRYL: Hey, thanks a lot, Howard.
HOWARD: Thanks for visiting the CNS Podcast. Please check back soon for the next in the series and visit our website, www.cnsproductions.com