Behavioral addiction
[3][4][6] Addiction canonically refers to substance abuse; however, the term's connotation has been expanded to include behaviors that may lead to a reward (such as gambling, eating, or shopping)[7] since the 1990s.[13] Similar to the changes in DSM-5, the eleventh revision of the International Classification of Diseases (ICD-11) introduced the category "Disorders due to substance use or addictive behaviours," based on the diagnostic framework of impaired control, repetitive harmful behavior, and continuation or escalation despite negative consequences.Therapeutic recreation can help an individual struggling with addiction to improve their self-esteem, confidence, motivation, resiliency, autonomy, enjoyment, and overall emotional state.[18] For example, this 2020 narrative review[17] considered ICD-11's guidelines to be adequate to include more behavioral addictions based on clinical relevance and empirical evidence, while this 2015 journal article questioned[26] the atheoretical and confirmatory research approaches on the accuracy of qualitative factors and criticized the lack of consideration of social elements and psychological processes.A recent narrative review[27] in 2017 examined the existing literature for studies reporting associations between behavioral addictions (pathological gambling, problematic internet use, problematic online gaming, compulsive sexual behavior disorder, compulsive buying and exercise addiction) and psychiatric disorders.Research shows that dopaminergic projections from the ventral tegmental area facilitate a motivational or learned association to a specific behavior.Research specific to Parkinson's disease has led to identifying the intracellular signaling pathways that underlie the immediate actions of dopamine.