Frequent Questions Raised About Acne

Acne is a very common disease. People who have it tend to have similar kinds of questions about it and its treatment. This section addresses some of the common questions asked by people with acne. Please remember that your dermatologist is always the best source of specific information about your individual health issues, including acne.

Questions and Answer does follows:

1. What causes acne?

The causes of acne are linked to the changes that take place as young people mature from childhood to adolescence (puberty). The hormones that cause physical maturation also cause the sebaceous (oil) glands of the skin to produce more sebum (oil). The hormones with the greatest effect on sebaceous glands are androgens (male hormones), which are present in females as well as males, but in higher amounts in males.

Sebaceous glands are found together with a hair shaft in a unit called a sebaceous follicle. During puberty, the cells of the skin that line the follicle begin to shed more rapidly. In people who develop acne, cells shed and stick together more so than in people who do not develop acne. When cells mix with the increased amount of sebum being produced, they can plug the opening of the follicle. Meanwhile, the sebaceous glands continue to produce sebum, and the follicle swells up with sebum.

In addition, a normal skin bacteria called P. acnes, begins to multiply rapidly in the clogged hair follicle. In the process, these bacteria produce irritating substances that can cause inflammation. Sometimes, the wall of the follicle bursts, spreading inflammation to the surrounding skin. This is the process by which acne lesions, from blackheads to pimples to nodules, are formed.

2. I wash my face several times a day. Why do I still get acne?

Many people still believe that acne is caused by dirty skin. The truth is, washing alone will not clear up or prevent acne. Washing does, however, help remove excess surface oils and dead skin cells. Many people use all kinds of products, including alcohol-based cleansers, and scrub vigorously, only to irritate the skin further and worsen their acne. Washing the skin twice a day gently with water and a mild soap is usually all that is required. However, acne is actually caused by a variety of biologic factors that are beyond the control of washing. For that reason, you should use appropriate acne treatments for the acne.

3. Does stress cause acne?

Stress is commonly blamed for the development of acne. Stress can have many physiologic effects on the body, including changes in hormones that may theoretically lead to acne. In some cases the stress may actually be caused by the acne lesions, not the other way around! If the acne is being treated effectively, stress is not likely to have much impact on the majority of people.

4. I never had acne as a teenager. Why am I now getting acne as an adult?

Usually, acne begins at puberty and is gone by the early 20s. In some cases, acne may persist into adulthood. Such types of acne include severe forms that affect the body as well as the face (which afflict males more than females) and acne associated with the menstrual cycle in women. In other cases, acne may not present itself until adulthood. Such acne is more likely to affect females than males.

There are several reasons for this. As females get older, the pattern of changes in hormones may itself change, disposing sebaceous glands to develop acne. Ovarian cysts and pregnancy may also cause hormonal changes that lead to acne. Some women get acne when they discontinue birth control pills that have been keeping acne at bay. Sometimes young women may wear cosmetics that are comedogenic-that is, they can set up conditions that cause comedones to form.

5. What role does diet play in acne?

Acne is not caused by food. Following a strict diet will not, clear your skin. While some people feel that their acne is aggravated by certain foods, particularly chocolate, colas, peanuts, shellfish and some fatty foods, there is no scientific evidence that suggests food causes or influences acne. Avoid any foods which seem to worsen your acne and, for your overall health, eat a balanced diet--but diet shouldn't really matter if the acne is being appropriately treated.

6. Does the sun help acne?

Many patients feel that sunlight improves their acne lesions and go to great lengths to find sources of ultraviolet light. There is no proven effect of sunlight on acne. In addition, ultraviolet light in sunlight increases the risk of skin cancer and early aging of the skin. It is, therefore, not a recommended technique of acne management, especially since there are many other proven forms of treatment for acne. Moreover, many acne treatments increase the skin's sensitivity to ultraviolet light, making the risk of ultraviolet light exposure all the worse.

7. What is the best way to treat acne?

Everyone's acne must be treated individually. If you have not gotten good results from the acne products you have tried, consider seeing a dermatologist. Your dermatologist will decide which treatments are best for you. For more information about the types of acne treatments that are available, and for basic acne treatment guidelines, please see Acne Treatments in the main part of AcneNet.

8. What kind of cosmetics and cleansers can an acne patient use?

Look for "noncomedogenic" cosmetics and toiletries. These products have been formulated so that they will not cause acne.

Some acne medications cause irritation or pronounced dryness particularly during the early weeks of therapy, and some cosmetics and cleansers can actually worsen this effect. The choice of cosmetics and cleansers should be made with your dermatologist or pharmacist.

Heavy foundation makeup should be avoided. Most acne patients should select powder blushes and eye shadow over cream products because they are less irritating and noncomedogenic. Camouflaging techniques can be used effectively by applying a green undercover cosmetic over red acne lesions to promote color blending.

9. Is it harmful to squeeze my blemishes?

Yes. In general, acne lesions should not be picked or squeezed by the patient. In particular, inflammatory acne lesions should never be squeezed. Squeezing forces infected material deeper into the skin, causing additional inflammation and possible scarring.

10. Can anything be done about scarring caused by acne?

Scarring is best prevented by getting rid of the acne. Dermatologists can use various methods to improve the scarring caused by acne. The treatment must always be individualized for the specific patient. Chemical peels may be used in some patients, while dermabrasion or laser abrasion may benefit others. It is important that the acne be well controlled before any procedure is used to alleviate scarring.

11. How long before I see a visible result from using my acne medication?

The time for improvement depends upon the product being used, but in almost all cases it is more a matter of weeks or months instead of days. Most dermatologists would recommend the use of a medication or combination of medications daily for 4 to 8 weeks before they would change the treatment. It is very important for patients to be aware of this time frame so they do not become discouraged and discontinue their medications. Conversely, if you see no change whatsoever, you might want to check with your dermatologist regarding the need to change treatments.

12. Would using my medication more frequently than prescribed speed up the clearing of my acne?

No--always use your medication exactly as your dermatologist instructed. Using topical medications more often than prescribed may actually induce more irritation of the skin, redness and follicular plugging, which can delay clearing time. If oral medications are taken more frequently than prescribed, they won't work any better, but there is a greater chance of side effects.

13. My topical treatment seems to work on the spots I treat, but I keep getting new acne blemishes. What should I do?

Topical acne medications are made to be used on all acne-prone areas, not just individual lesions. Part of the goal is to treat the skin before lesions can form and to prevent formation, not just to treat existing lesions. Patients are generally advised to treat all of the areas (forehead, cheeks, chin and nose) that tend to break out rather than just individual lesions.

14. My face is clear! Can I stop taking my medication now?

If your dermatologist says you can stop, then stop--but follow your dermatologist's instructions. Many times patients will stop their medication suddenly only to have their acne flare up several weeks later. If you are using multiple products, it may be advisable to discontinue one medication at a time and judge results before discontinuing them all at once. Ask your dermatologist before you stop using any of your medications.

15. Does it matter what time I use my medication?

Check with your dermatologist or pharmacist. If you were taking one dose a day of an antibiotic, you could probably take it in the morning, at midday or in the evening, although you should pick one time of day and stay with it throughout your treatment. With oral medications prescribed twice a day or three times a day, you should try your best to spread out the doses evenly. Some antibiotics should be taken on an empty or nearly empty stomach. For optimal results with topical treatments, you should strictly follow your dermatologist's recommendations. For example, if instructed to apply benzoyl peroxide in the morning and a topical retinoid at bedtime, it is important to follow these directions strictly. If the two were applied together at bedtime, for example, you could decrease the efficacy of the treatment because of chemical reactions that make them less effective.

16. I have trouble remembering to take my oral medication every day. What's a good way to remember? What should I do if I forget a dose?

This is a common problem. Many patients try to associate taking their medication with a routine daily event such as brushing teeth or applying makeup. It also helps to keep the medication close to the area where the reminder activity is carried out.

In most cases, if you miss a day of your oral treatment, do not double up the next day; rather, get back to your daily regimen as soon as possible--but there may be different instructions for different oral medications. Ask your dermatologist or pharmacist about what to do if you miss a dose of your particular medication.

17. I have been using topical benzoyl peroxide and an oral antibiotic for my acne and have noticed blue-black and brown marks developing on my face and some discoloration on my body. The marks are especially noticeable around acne scars and recently healed lesions. Is this a side effect of medication and is it permanent?

It is not possible to make general statements about side effects of medications that apply to individual cases. A dermatologist should be consulted. The facial marks and body discoloration described by the patient in this case do fall within the range of side effects of some antibiotics.

Unique patterns of pigmentation are sometimes seen in acne patients treated with certain oral antibiotics

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9 Steps To Cleaner And Healthier Skin

According to Bestskinpeel, for cleaner, healthier and easier to manage skin just follow this list of nine items:

1) Lower your stress level through prayer and meditation. Stress creates hormones that actually age us as they destroy cells and create toxic biproducts and free radicals. Studies have shown that prayer and meditation can reduce our stress levels. Prayer and meditation have been proven to even alleviate some of the symptoms of cancer and other life threatening diseases.

2) Drink plenty of water. It is a fact that 90% of us do not drink enough water. For your skin cells to function properly and heal properly from cuts, etc... we need to drink 8-12 glasses of water every day. Our skin is one of our most important organs as it protects us from disease, cushions our falls, etc... It needs plenty of water.

3) Get proper sleep. Not getting the proper 8-10 hours of sleep per day will first show in your skin. Broken capillaries, puffiness, circles under the eyes.

4) Eat well. Get proper nutrition. Too many junk foods can cause or worsen skin problems like pimples and acne. A well balanced meal 3 times per day has been proven to help alleviate spikes in skin problems and help to average out the outbreaks in acne vulgaris.

5) Take vitamins to supplement your skin and body. We can't always make sure we get 100% of each vitamin and mineral with the foods we eat, but we can take a multivitamin once a day. They are cheap at Walmart and there is no excuse. People that take multivitamins once a day live longer. Its a proven fact just like persons that smoke take years off their lives.

6) Properly clean your skin. Harsh soaps can dry out your skin and even stimulate further sebum (oil) production which can worsen acne. Use a mild cleanser with 2% salicylic acid. This has been proven very effective in ridding excess oils while maintaining proper hydration and pH. The slight acidity will keep bacteria at bay.

7) Don't smoke. Smoking puts years on you. Literally, smoking can add 10 years to the aged look of your skin. Why would you want to do that? If you must have nicotine then get nicotine gum or the patch - they will cure your cravings and there is no evidence or statistics of anyone developing cancer, lung disease, etc... from these.

8) Wear sunscreen. The skin does have keratonin to protect against the suns rays, but it is no match for UV rays, etc... that we expose ourselves to. Melanoma has several forms and all are deadly. If you don't think you will get skin cancer or think you are invulnerable, just go to your local dermatologist and ask to see pictures of clients with skin cancer, better yet go to the oncology center at your local hospital. You won't think that way ever again. Wear sunscreen.

9) Treat yourself to a spa treatment atleast once a year. Skin peels, TCA peels, deep tissue massage, complete relaxation, aromatherapy, etc... will all energize and heal your skin. TCA peels will actual improve your skins ability to regenerate itself and improve collagen levels.

Remember, follow these nine steps to enjoy healthier skin.

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Religious Fanaticism and Poly-behavioral Addiction

Surveys show that religion and spirituality play a central role in the lives of most of the population in human experience. Gallup (2004) found that 59% of adults nationwide say religion is a very important part of their lives. An additional 26% of Americans say religion is fairly important to them. Just 15% of respondents say religion is not very important. About two-thirds of Americans, 64%, belong to a church or synagogue. The religious and spiritual dimensions of culture were found to be among the most important factors that structure human experience, beliefs, values, behavior, and illness (Browning et al., 1990 James, 1961 Krippner and Welch, 1992).

Researchers however, report that some individuals seem to get fanatical about thier religion and develop maladaptive behaviors. Members of the American Psychological Association reported that at least one in six of their clients presented issues that involve religion or spirituality (Shafranske and Maloney, 1990). In another study, 29% of psychologists agreed that religious issues are important in the treatment of all or many of their clients (Bergin and Jensen, 1990, p. 3). Psychotherapy can sometimes be effective in treating religious problems. Robinson (1986) noted, "Some patients have troublesome conflicts about religion that could probably be resolved through the process of psychotherapy" (p.22).

Religious problems can be as various and complex as mental health problems. One type of psychoreligious problem involves patients who intensify their adherence to religious practices and orthodoxy (Lukoff, Lu, and Turner 1992, p. 677). Generally when people speak of addictive diseases they imply a medical problem. In the past few years the term addiction has been used to characterize behaviors that go beyond chemicals. Dr. Robert Lefever (1988) views addiction as a "family disease" involving self-denial and caretaking, domination, and submission (p. ix). Gerald May (1988) states that addiction is a "state of compulsion, obsession, or preoccupation that enslaves a person's will and desire" (p.14). Shaef (1987) defines addiction as "any process over which we are powerless" (p. 18). She divides addictions into two categories: substance addictions -alcohol, drugs, nicotine, food) and process addictions -money-accumulation, gambling, sex, work, worry, and religion.

Research in the area of religious addiction is deficient, however there were a few older related studies found in the literature. Simmonds (1977) reports that there is some evidence to indicate that "religious people in general tend to exhibit dependency on some external source of gratification" (p. 114). Black and London (1966) found a high positive correlation between the variables of obedience to parents and country and indices of religious belief such as church attendance, belief in God and prayer (p. 39). Goldsen, et al. (1960) showed that people who were more religious consistently showed tendencies toward greater social conformity than did the nonreligious, a finding consistent with the notion that religious people seek external approval. These results are supported by Fisher (1964 p. 784), who reported that a measure of social approval and religion were strongly associated. Religious people show dependence not only on social values, but also on other external agen ts. Duke (1964, p. 227) found that church attendance indicated more responsiveness to the effects of a placebo. In a study of 50 alcoholics, it was found that those who were dependent on alcohol were more likely to have had a religious background (Walters, 1957, p. 405).

The few research studies aforementioned seem to suggest that religious people develop a dependency on religious practices for social approval. Since religious people seem to be describable in terms of relatively high levels of dependence, it seems useful to borrow a concept suggested by Peele and Brodsky (1975)- that of "addiction." According to these writers addiction is "a person's attachment to a sensation, an object, or another person... such as to lessen his appreciation of and ability to deal with other things in his environment, or in himself, so that he has become increasingly dependent on that experience as his only source of gratification" (p. 168).

There are a variety of definitions for the concept of religious addiction. Arterburn and Felton (1992) state that "when a person is excessively devoted to something or surrenders compulsively and habitually to something, that pathological and physiological dependency on a substance, relationship, or behavior results in addiction" (p. 104). They indicate that, "like any other addiction, the practice of religion becomes central to every other aspect of life...all relationships evolve from the religion, and the dependency on the religious practice and its members removes the need for a dependency on God...the religion and those who practice it then become the central power for the addict who no longer is in touch with God" (p. 117).

Spirituality can also have pathological aspects to it. Vaughan (1991) reports that "the shadow side to a healthy search for wholeness can be called addiction to spirituality" (p. 105). He indicates that this can be found among people who use spirituality as a solution to problems they are unwilling to face. Van-Kaam (1987) presents a viewpoint of addiction as a quasi religious or falsified religious presence. He reports that "an understanding of the relationship between religious presence and addiction allows potential dangers of receptivity to be identified in order to realize the real value of true religious presence and the shame of its counterfeit, addiction" (p. 243). McKenzie (1991) discusses addiction as an unauthentic form of spiritual existence. He says that, "addiction is born of the human desire for transcendence which is often perverted or misplaced by societies that encourage their members to seek ultimate meaning in dimensions that have no regard for the tra nscendent" (p. 325). Heise (1991, p. 11) explores the fundamentalist Christian's focus on perfectionism, and it's possible contribution to an increase in dysfunctional individuals, family systems, and addictions.

Until recently, research in this area has primarily focused on religious cults. Estimates of the number of cults range from several hundred to several thousand, with a total membership up to three million (Allen and Metoyer, 1988, p. 38 Melton, 1986). According to Margaret Singer, Ph.D., a psychologist specializing in cult phenomena, "the word cult describes a power structure,...what really sets a cult apart is that one person has proclaimed himself to have some special knowledge, and if he can convince others to let him be in charge, he will share that knowledge" (Collins & Frantz, 1994, p. 30). The Jim Jones People's Temple mass suicide has been documented in the news, and more recently David Koresh's Branch Davidian Christian cult. Cults, both destructive and benign, have been with us in various guises since time immemorial. Many psychologists and psychiatrists have become knowledgeable about destructive cults in the course of their work with patients affected by the p roblem.

Within the past few years, however, traditional Church members have faced their compulsive behavior and harmful beliefs. Doucette (1992) reports that "many people are waking up because they have seen their religious leaders fall. Some researchers believe that the magnitude of the tragedy of religious addiction and abuse was revealed by the TV evangelist scandals documented in the news media which involved: Jim and Tammy Bakker Jimmy Swaggart and Oral Roberts (Brand 1987, p. 82 Woodward 1987, p. 68 and Kaufman 1988, p. 37). These personal confessions have exposed not only how these supposed men of God had betrayed people's trust, but how many of those who had been abused, betrayed, and bankrupted never seemed to question what was happening and continued to support these individuals.

Booth (1991) states that "the Bakker, Swaggart, and Roberts scandals created a national intervention that served to interrupt the progress of this unhealthy phenomenon" (p. 38). What had previously been viewed as fanaticism or zealotry increasingly began to be called religious addiction and religious abuse. Booth (1991) defines religious addiction as "using God, a church, or a belief system as an escape from reality, or as a weapon against ourselves or others in an attempt to find or elevate a sense of self-worth or well-being" (p. 38).

Other researchers use the terms spiritual and psychological abuse to describe the characteristics of religious addiction. Enroth (1992) says that his book "Churches That Abuse is about people who have been abused psychologically and spiritually in churches and other Christian organizations" (p. 29). He reports that "unlike physical abuse that often results in bruised bodies, spiritual and pastoral abuse leaves scars on the psyche and soul...the perversion of power that we see in abusive churches disrupts and divides families, fosters unhealthy dependence of members on the leadership, and creates, ultimately, spiritual confusion in the lives of victims" (p. 29). The scandals involving TV evangelists created a national intervention by bringing religious addiction and abuse too close to home to be ignored. Those scandals spurred people to act and call for change.

During this period, I had the unique opportunity to conduct a literature review and survey on the relatively newly recognized phenomenon of religious addiction within Christianity in the State of Hawaii for my dissertation while pursuing my doctor of psychology degree (Psy.D) in clinical psychology. After studying the symptoms, beliefs, and stages of religious addiction along with the characteristics of religiously addictive organizations, I came to believe that having an intense faith or religious ferver is not equal to having a religious addiction. Most people experience healthy religion and a spiritual life in which obedience to God is balanced with a freedom to serve others in ways of individual experession.

I also discovered however, that church leaders in Hawaii that were self-appointed (not elected/ appointed by their church) significantly identified more with religious addictive beliefs, symptoms and practices compared to their counterparts.

Multiple Addictions

Compulsive religiosity sometimes accompanies other addictions as the religious addict is seeking to lessen guilt and shame. Since it is impossible to expect treatment for one addiction to be beneficial when other addictions co-exist, the initial therapeutic intervention for any addiction needs to include an assessment for other addictions. In my clinical practice, I have noticed a significant correlation between religious addiction and other substance abuse and behavioral addictions such as chemical dependency, alcoholism, pathological gambling, and food addictions.

Poor Prognosis

We have come to realize today more than any other time in history that the treatment of lifestyle diseases and addictions are often a difficult and frustrating task for all concerned. Repeated failures abound with all of the addictions, even with utilizing the most effective treatment strategies. But why do 47% of patients treated in private addiction treatment programs (for example) relapse within the first year following treatment (Gorski, T., 2001)? Have addiction specialists become conditioned to accept failure as the norm? There are many reasons for this poor prognosis. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. Others would say that failures are due simply to a lack of self-motivation or will power. Most would agree that lifestyle behavioral addictions are serious health risks that deserve our attention, but could it possibly be that patients wit h multiple addictions are being under diagnosed (with a single dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with multiple addictions?

Diagnostic Delineation

Thus far, the DSM-IV-TR has not delineated a diagnosis for the complexity of multiple behavioral and substance addictions. It has reserved the Poly-substance Dependence diagnosis for a person who is repeatedly using at least three groups of substances during the same 12-month period, but the criteria for this diagnosis do not involve any behavioral addiction symptoms. In the Psychological Factors Affecting Medical Conditions section (DSM-IV-TR, 2000) maladaptive health behaviors (e.g., unsafe sexual practices, excessive alcohol, drug use, and over eating, etc.) may be listed on Axis I, only if they are significantly affecting the course of treatment of a medical or mental condition.

Since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning, it is no wonder that repeated rehabilitation failures and low success rates are the norm instead of the exception in the addictions field, when the latest DSM-IV-TR does not even include a diagnosis for multiple addictive behavioral disorders. Treatment clinics need to have a treatment planning system and referral network that is equipped to thoroughly assess multiple addictive and mental health disorders and related treatment needs and comprehensively provide education/ awareness, prevention strategy groups, and/ or specific addictions treatment services for individuals diagnosed with multiple addictions. Written treatment goals and objectives should be specified for each separate addiction and dimension of an individuals life, and the desired performance outcome or completion criteria should be specifically stated, behaviora lly based (a visible activity), and measurable.

New Proposed Diagnosis

To assist in resolving the limited DSM-IV-TRs diagnostic capability, a multidimensional diagnosis of Poly-behavioral Addiction, is proposed for more accurate diagnosis leading to more effective treatment planning. This diagnosis encompasses the broadest category of addictive disorders that would include an individual manifesting a combination of substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). Behavioral addictions are just as damaging - psychologically and socially as alcohol and drug abuse. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. They are progressive disorders that involve obsessive thinking and compulsive behaviors. They are also characterized by a preoccupation with a continuous or periodic loss of c ontrol, and continuous irrational behavior in spite of adverse consequences.

Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. These various types of intoxication are produced by repeated obsessive thoughts and compulsive practices involved in pathological relationships to any mood-altering substance, person, organization, belief system, and/ or activity. The individual has an overpowering desire, need or compulsion with the presence of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is always physical and/ or psychic dependence on the effects of this pathological relationship. In addition, there is a 12 - month period in which an individual is pathologically involved with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in particular (Slobodzien, J. , 2005). In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on multiple physiologically addictive substances and behaviors (e.g., using/ abusing substances - nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously.

Conclusion

Considering the wide range of religious behaviors in our world today, one should always take into account an individuals ethnic, cultural, spiritual, and social background prior to making any clinical judgments, and it would be wise to not over-pathologize in this area of Religious Addiction. However, since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning - poly-behavioral addiction needs to be identified to effectively treat the complexity of multiple behavioral and substance addictions.

Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed - how should we effectively manage poly-behavioral addiction?

The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individuals comprehensive life-functioning progress dimensions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individuals develop to any one form of treatment to a single dimension of their lives, because the effects of an individuals addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to imp rove overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individuals primary addiction. The ARMS theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individuals life dimensions in addition to developing specific goals and objectives for each dimension.

Partnerships and coordination among service providers, government departments, and community organizations in providing addiction treatment programs are a necessity in addressing the multi-task solution to poly-behavioral addiction. I encourage you to support the addiction programs in America, and hope that the (ARMS) resources can assist you to personally fight the War on poly-behavioral addiction.

For more info see: Poly-Behavioral Addiction and the Addictions Recovery Measurement System (ARMS) By James Slobodzien, Psy.D. CSAC at: /drslbdzn/Behavioral_Addictions.html

Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS)

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For more info see: Hawaii and Christian Religious Addiction

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Addictions Recovery Management Services

/drslbdzn/Behavioral_Addictions.html

James Slobodzien, Psy.D., CSAC, is a Hawaii licensed psychologist and certified substance abuse counselor who earned his doctorate in Clinical Psychology. He is credentialed by the National Registry of Health Service Providers in Psychology. He has over 20-years of mental health experience primarily working in the fields of alcohol/ substance abuse and behavioral addictions in hospital, prison, and court settings. He is an adjunct professor of Psychology and also maintains a private practice as a mental health consultant.

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