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Johnson, B. (2003). Psychological Addiction, Physical Addiction, Addictive Character, and Addictive Personality Disorder: A Nosology of Addictive Disorders. Canadian J. Psychoanal., 11(1):135-160.

(2003). Canadian Journal of Psychoanalysis, 11(1):135-160

Psychological Addiction, Physical Addiction, Addictive Character, and Addictive Personality Disorder: A Nosology of Addictive Disorders

Brian Johnson

In order to establish a new nosology of addictive disorders, the neurobiology of withdrawal and craving are reviewed, followed by a review of the psychoanalytic literature on addictive neuropsychodynamics.

New information allows us to refine our understanding of addiction. One type of addiction is a character type; a second is a biological disorder. Addictive character is a repetitive, stereotyped response to helplessness via compulsive behaviours. Physical addiction is due to an upregulation of the ventral tegmental dopaminergicpathway with lifelong drug craving and drug dreams. Both disorders have overlapping features including idealization of the addictive behaviour, a denial system, and resort to addictive behaviours under stress. DSM-type diagnostic criteria are proposed.

The nosology helps to clarify the relationship of non-drug to drug addictions. For example, gambling or shopping addiction exists only as a psychological addiction, whereas alcohol or opiate addiction can be either psychological or physical or both. Use of the refined diagnostic concepts aids in treatment planning and in understanding the relationship of addictive disorders to other forms of psychopathology.

Afin d'établir une nouvelle nosologie des troubles de la dépendance, on examine d'abord la neurobiologie du sevrage et de l'état de manque, avec ensuite un survol des publications psychanalytiques sur la neuropsychodynamique de la dépendance.

De nouvelles données nous aident à raffiner notre compréhension de la dépendance. Un type de dépendance relève du caractère, alors

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