Compulsivity, Impulsivity, and Addiction

Source: https://slideplayer.com/slide/13403973/

Considering the variety of topics the Support Plus Community supports, I thought this would be a good post that everyone could engage in regarding compulsivity, impulsivity, and addiction.

Let's start with some definitions!

Compulsivity- According to Bethany Cook, PsyD, a clinical psychologist in Chicago, compulsive behaviors are conscious or unconscious actions. Compulsive behaviors are usually performed repeatedly to reduce emotional or somatic physical discomfort — or in other words, relieve an urge or distress.

Examples of Compulsive Disorders:

obsessive-compulsive disorder (OCD)

body dysmorphic disorder (BDD)

hoarding disorder

trichotillomania (or hair pulling disorder)

dermatillomania (excoriation or skin picking disorder)

substance or medication-induced obsessive-compulsive and related disorder

obsessive-compulsive and related disorder due to another medical condition

Impulsivity- Impulsive behaviors are spontaneous actions that aren’t completely thought out, particularly regarding the potential consequences. Everyone is prone to acting impulsively given circumstances, whereas not everyone performs repetitive behaviors or thoughts in an effort to feel better.

Examples of Impulsive Disorders:

oppositional defiant disorder (ODD)

intermittent explosive disorder (IED)

conduct disorder

pyromania

kleptomania

In impulse control disorders, an increasing tension and arousal occurs before the impulsive act, with pleasure, gratification, or relief during the act. Following the act, there may or may not be regret or guilt. Positive reinforcement (pleasure/gratification) is more closely associated with impulse control disorders.

In compulsive disorders, there are recurrent and persistent thoughts (obsessions) that cause marked anxiety and stress followed by repetitive behaviors (compulsions) that are aimed at preventing or reducing distress. Negative reinforcement (relief of anxiety or relief of stress) is more closely associated with compulsive disorders

Impulsivity and compulsivity can interconnect to results in the addiction cycle, conceptualized as three major components: preoccupation/anticipation, binge/ intoxication, and withdrawal/negative affect. There are changes in the contribution of positive and negative reinforcement during the development of substance dependence (i.e. alcohol).

source: https://www.researchgate.net/publication/316024878_Neuroclinical_Framework_for_the_Role_of_Stress_in_Addiction/figures?lo=1

As you can see in the image above, the impulsivity and reward of the substance is the starting point, and eventually as the addiction takes hold there is more "compulsivity" that takes over.

Similar mechanisms have been found not only in substance addiction but also "behavioral addictions." However, there seems to be ongoing research about the contribution of impulsivity and compulsivity across substance and behavior addictions that are being re-evaluated.

https://pubmed.ncbi.nlm.nih.gov/30927147/

https://www.sciencedirect.com/science/article/pii/B9780124077249000021

There are even some studies attempting to look at the contribution of impulsivity and how OCD might be a form of behavioral addiction rather than purely compulsive: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712760/

Discussion:

1. What do you think about the connection between impulsivity, compulsivity, and addiction?

2. Do you have experience with one or more of these? (if willing to share)

3. How you found ways to cope with one of more of these behaviors?

Additional Citations:

https://psychcentral.com/ocd/compulsive-vs-impulsive#takeaway

https://pediaa.com/what-is-the-difference-between-impulsive-and-compulsive/

༼ つ ◕_◕ ༽つ***Disclaimer: I am not a healthcare professional, just a member sharing information, experience, strength, and hope. Please seek professional care for mental health advice.