title: Social judgments of behavioral versus substance-related addictions: a population-based study.
abstract: BACKGROUND
  Recently, the concept of addiction has expanded to include many types of problematic repetitive behaviors beyond those related to substance misuse. This trend may have implications for the way that lay people think about addictions and about people struggling with addictive disorders. The aim of this study was to provide a better understanding of how the public understands a variety of substance-related and behavioral addictions.
  
  
  METHODS
  A representative sample of 4000 individuals from Alberta, Canada completed an online survey. Participants were randomly assigned to answer questions about perceived addiction liability, etiology, and prevalence of problems with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (problematic gambling, eating, shopping, sexual behavior, video gaming, and work).
  
  
  RESULTS
  Bivariate analyses revealed that respondents considered substances to have greater addiction liability than behaviors and that most risk factors (moral, biological, or psychosocial) were considered as more important in the etiology of behavioral versus substance addictions. A discriminant function analysis demonstrated that perceived addiction liability and character flaws were the two most important features differentiating judgments of substance-related versus behavioral addictions. Perceived addiction liability was judged to be greater for substances. Conversely, character flaws were viewed as more associated with behavioral addictions.
  
  
  CONCLUSIONS
  The general public appreciates the complex bio-psycho-social etiology underlying addictions, but perceives substance-related and behavioral addictions differently. These attitudes, in turn, may shape a variety of important outcomes, including the extent to which people believed to manifest behavioral addictions feel stigmatized, seek treatment, or initiate behavior changes on their own.
authors.affiliation: Department of Psychology, University of Calgary, 2500 University Drive, Calgary T2N 1N4, Canada. Electronic address: bkonkoly@ucalgary.ca.
authors.forename: Barna
authors.initials: B
authors.lastname: Konkolÿ Thege
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Room 3105, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada. Electronic address: icolman@uottawa.ca.
authors.forename: Ian
authors.initials: I
authors.lastname: Colman
authors.affiliation: Department of Psychiatry, University of Calgary, 1403-29 Street, Calgary T2N 2T9, Canada. Electronic address: nady.el-guebaly@albertahealthservices.ca.
authors.forename: Nady
authors.initials: N
authors.lastname: el-Guebaly
authors.affiliation: Department of Psychology, University of Calgary, 2500 University Drive, Calgary T2N 1N4, Canada. Electronic address: dhodgins@ucalgary.ca.
authors.forename: David C
authors.initials: DC
authors.lastname: Hodgins
authors.affiliation: Department of Psychiatry, University of Calgary, 1403-29 Street, Calgary T2N 2T9, Canada; Department of Community Health Sciences, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive, Calgary T2N 4Z6, Canada. Electronic address: patten@ucalgary.ca.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Patten
authors.affiliation: School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-97 Avenue, Edmonton T6G 1C9, Canada. Electronic address: donald.schopflocher@ualberta.ca.
authors.forename: Don
authors.initials: D
authors.lastname: Schopflocher
authors.affiliation: School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-97 Avenue, Edmonton T6G 1C9, Canada. Electronic address: jody.wolfe@ualberta.ca.
authors.forename: Jody
authors.initials: J
authors.lastname: Wolfe
authors.affiliation: School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-97 Avenue, Edmonton T6G 1C9, Canada. Electronic address: cam.wild@ualberta.ca.
authors.forename: T Cameron
authors.initials: TC
authors.lastname: Wild
mesh_terms: D000328:Adult; D000416:Alberta; D000437:Alcoholism; D001294:Attitude to Health; D016739:Behavior, Addictive; D019970:Cocaine-Related Disorders; D016002:Discriminant Analysis; D001068:Feeding and Eating Disorders; D005260:Female; D005715:Gambling; D006801:Humans; D007600:Judgment; D008297:Male; D002189:Marijuana Abuse; D008875:Middle Aged; D011639:Public Opinion; D012725:Sexual Behavior; D057545:Social Stigma; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder; D018910:Video Games
keywords: Behavioral addictions; Etiology; Lay theory; Stigma; Substance-related addictions