Addictions Not Related to the Use and Abuse of Substances and Some Assessment Tools in the Clinical-Forensic Field

Abstract

Starting from the updated data on the topic and inherent to the research of the author (Calderaro M., and coordinated by Mastronardi V.) and carried out with the CSS (Superior Health Council) which approved the new concept of addiction as developed by the Working Group in charge and published on 12 October 2022 (see sitography) and ultimately for the new 'concept of addiction', that is, a "psychic condition, (maladaptive) which does not exclude physical discomfort resulting from the interaction between a dysfunctional behaviour and/or a substance and an organism, characterised by an absolute need to continue to experience the inebriating effects of the same psychophysical and biological satisfactions, therefore with an increase in endorphinic gratification, albeit fictitiously, involving the limbic area of our brain with its centres of gratification and punishment". The deepest motivations that drive and/or support dysfunctional addictive behaviour can be considered common to almost all addictions and can be summarised as follows: a) to soothe pain, b) out of curiosity or exploratory instinct, c) for pleasure, d) for escape, e) out of desperation, f) out of nonconformity, g) for imitation, h) to create and ritualise social bonds, i) for compensation [for a psychoneurotic syndrome]. The new official research by the Study Group of the Higher Health Council on addictions not due to the use of substances, has drawn inspiration from the need for assistance by the National Health Service to guarantee assistance not only for cases of "addiction linked to the use of substances", but also for that "not due to the use of substances". In fact, for some time now we no longer speak of SERT, but of SERD where the last letter is no longer (Drug Addiction), but the letter D which stands for Dependence Tout Court. Obviously the difficulty lies in finding the evaluation tools capable of discerning what constitutes a pathological dependence from a non-pathological one deserving of assistance by the National Health Service itself. For this topic, please refer to the specific chapter. In the English language, ‘addiction’ means the behaviour that leads to psychological dependence, vice versa, fore ‘dependence’ means that dependence that involves both a physical and chemical dependence in order to function. Therefore, this work has the purpose of examining, among others, diagnostic-evaluative aspects in function of the operational treatment tools relating to the individual behavioural dependencies that are listed below.