Reframing Addiction as a Coping Response: A Needed Shift in Modern Public Health Paradigms

What are the primary risk factors that compel one person towards addiction and not another? After decades of research, there is still no clear consensus. Some experts say addiction is a brain disease; others say it is a willful act, or even an outright crime. Nevertheless, the three research studies contained within this dissertation suggest an alternative, more parsimonious public-health-centered framework for viewing addictive behavioral patterns: as a biopsychosocial coping strategy for past and present stressors. In Study 1, this idea was examined by evaluating how symptoms of posttraumatic stress disorder (PTSD) were associated with problem gambling severity, different gambling motives, and positive play practices (i.e., responsible gambling behaviors and beliefs) using a census-matched sample of adults from the United States (U.S.; N = 2,806). In Study 2, the same sample was used, but this time, the relationships between PTSD symptoms, motives for playing video games, and gaming disorder severity were investigated. Finally, in Study 3, the connections between 10 categories of adverse childhood experiences and 13 types of significant problems involving substances (e.g., alcohol, cocaine) and/or behaviors (e.g., gambling, internet use) were investigated amongst a large sample of U.S. college students (N = 1,993). Collectively, the results from this work point to an often forgotten truth about substance and behavioral addictions: they are developed in response to a person’s past experiences and current milieu. When addiction is viewed this way, it permits the possibility of finding more pragmatic solutions beyond medical treatments and the legal system for helping individuals struggling with these sometimes useful but often harmful coping strategies.