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A maladaptive pattern of substance use (behaviors or relationship), leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
(1) tolerance, as defined by either of the following:
(a) a need for markedly increased amounts of the substance (behaviors or relationship) to achieve intoxication or desired effect(b) markedly diminished effect with continued use of the same amount of the substance (behaviors or relationship)
(2) withdrawal, as manifested by either of the following:
(a) the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)(b) the same (or a closely related ) substance (behaviors or relationship) is taken to relieve or avoid withdrawal symptoms
(3) the substance (behaviors or relationship) is often taken in larger amounts or over a longer period than was intended
(4) there is a persistent desire or unsuccessful efforts to cut down or control substances (behaviors or relationship) use
(5) a great deal of time is spent in activities necessary to obtain the substance (behaviors or relationship) (e.g., visiting multiple doctors or driving long distances), use the substance (e.g. chain-smoking, weekend trips to gamble at casinos, frequent traveling out of town to visit partner), or recover from its effects
(6) important social, occupational, or recreational activities are given up or reduced because of substance use (behaviors or relationship)
(7) the substance use (behaviors or relationship) is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (behaviors or relationship) (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption, (continuing relationship despite recurrent experiences of hurt and abandonment, depression and anxiety)
a need for markedly increased sexual frequency (instead of amounts of the substance) to achieve intoxication or desired effectmarkedly diminished effect with continued use of the same frequency or type of sex.
the characteristic withdrawal syndrome for the stopping or curtailing Internet addictionthe same Internet behavior is taken to relieve or avoid withdrawal symptoms
as gambling occurs in larger amounts of time or money gambled or over a longer period than was intendedthere is a persistent desire or unsuccessful efforts to cut down or control gamblinga great deal of time is spent in activities necessary to gambling (e.g., visiting multiple bookies or casinos or, frequent traveling out of town to visit partner), or recover from its effects
important social, occupational, or recreational activities are given up or reduced because of eating compulsions or food addictioneating compulsions or food addiction is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the eating compulsions or food addiction (e.g., current eating compulsions or food addiction despite recognition of eating or food-induced depression, or recognition that unhealthy medical consequences were made worse by eating compulsions or food addiction.