Once substance dependence develops, a progressive series of self-reinforcing symptoms begin to develop. Two models of the progressive symptoms will be presented: (1) The DSM-IV Progressive Symptom Model; and (2) The Biopsychosocial Progressive Symptom Model.
The DSM IV Progressive Symptom Model was developed by completing a three step procedure:
Step 1: Analyzing the DSM-IV criteria for substance use disorders,
Step 2: Dividing specific criteria that contained more than one identifiable symptom into separate symptoms,
Step 3: Arranging the symptoms in a logical progression supported by both face validity and studies of widely accepted models that sequence addiction symptom development (Jellinek 1960; Glatt 1982; APA 1994, NIAAA 1995).
The Biopsychosocial Progressive Symptom Model was developed by completing the following steps:
Step 1: Reviewing past progressive symptom model (Jellinek 1960; Glatt 1982),
Step 2: Reviewing recent related to models of addiction containing biological, psychological, or social symptoms (Tarter et al 1988; Tabakoff 1988; NIAAA 1996; NIAAA 1995);
Step 3: Isolating specific symptoms from all models, grouping into similar categories, and eliminating duplication; and
Step 4: Integrating the newly identified symptoms into the The DSM-IV Progressive Symptom Model in proper order of development.