Chad Hills, policy analyst for Focus on the Family, said the classification will add “legitimacy” to the problem of excessive gambling.
Gambling advocacy organizations have “tried to frame gambling addiction as a person’s weakness, a person’s irresponsible behavior, as a general malfunction in a person,” said Mr. Hills, whose group opposes gambling. “I was glad to see it recognized by the psychiatric community as a legitimate addiction.”
Two more DSM-V changes welcomed by practitioners are the creation of a “hypersexual disorder” under the category of Sexual and Gender Identity Disorders, and a new category for “binge eating” under Eating Disorders.
Hypersexual disorder refers to severe problems with sexual fantasies, urges or behaviors.
“If you are losing your job or losing a marriage or having health consequences because you’re having sex with prostitutes repeatedly, compulsively, or you are looking at porn at work even though you’ve been warned — those are above and beyond healthy sexual behaviors,” said John O’Neill, former director of addiction services at the Menninger Clinic in Houston.
Hypersexual disorder won’t apply to everyone who looks at pornography or has an affair, but it will finally address the serious problems, said Mr. O’Neill, who is now in private practice.
In the past, people have said, “Well, it’s not really a problem. … It’s a character flaw,” he said.
Now brain studies have shown that whether someone is addicted to sex or food or gambling or alcohol, “your brain has been rewired basically, to say, ‘This is what I have to have to experience pleasure, to feel good, to cope,’” Mr. O’Neill said.
Rebecca Wagner, who coordinates the eating disorder program at the Menninger Clinic, called the new binge-eating category “a very welcome change.”
Binge eating is different from anorexia or bulimia, she explained.
Binge eaters say they “can’t stop eating.” In a two-hour period, for instance, they will consume so much food that they will feel uncomfortable. They also are likely to eat when they are not hungry, eat secretly because of embarrassment and feel disgusted with themselves.
However, Ms. Wagner said, their attempts to restrict their eating typically leads to hunger and bingeing again. It’s a “vicious cycle,” said Ms. Wagner, who added that binge eaters often struggle with additional problems such as depression or anxiety.
The new DSM-V criteria should mean better diagnoses of this condition, which in turn should open the doors for insurance-covered treatment and additional research, she said.
Still, gambling, hypersexuality and binge eating all made Dr. Frances’ list of “19 worst suggestions” for the DSM-V.
“The tens of millions of people who binge eat once a week for three months would suddenly have a ‘mental disorder, subjecting them to stigma and medications with unproven efficacy,” Dr. Frances, professor emeritus at Duke University’s psychiatry department, wrote in a commentary column.