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Totally hooked: Angling, gambling, and ‘fishing addiction’

A few days ago, I published a short paper with Dr. Michael Auer examining the concept of ‘fishing addiction’ and the similarities with gambling addiction in the Archives of Behavioral Addiction. Fishing and gambling are two activities that on the surface do not appear to have much in common with each other. For many people, they are both simply leisure activities and this is where the similarities stop.

So in what ways are fishing and gambling similar? In the broadest of senses, gambling and fishing are not too dissimilar. As Dr. Gary Smith and his colleagues noted in a 2003 report, the word ‘gambling’ in day-to-day language has broad currency and can describe a number of activities such as farming, fishing, searching for oil, marriage or even crossing a busy street”. More specifically, in a 2011 chapter on stress among fisherman, Dr. Richard Pollnac and colleagues noted that “a fisher is basically gambling every time he/she goes out fishing” and that like gambling “production per fishing trip is highly variable and relatively unpredictable”. An earlier 2008 paper by Pollnac and John Poggie highlighted that marine fishing as an occupation is of a relative risky nature and state that it attracts and holds individuals manifesting an active, adventurous, aggressive and courageous personality – attributes that arguably apply to some types of competitive gamblers, such as poker players.

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According to a 2013 online article by Dr. Per Binde (2013), who describes himself as a gambling researcher that enjoys fishing in his spare time, gambling and fishing have many similarities “especially if you consider bait casting (spinning) in relation to repetitive forms of gambling, such as slot machines. A 2013 online article by Whitney James (2013) has also made a similar observation that “pulling a penny slot is like casting your line. It doesn’t take a lot of effort but the payout is sometimes sweet”. In fact, both Binde and James have noted a number of distinct similarities and the list below combines these along with some of our own observations:

  • In both activities, the participant repeats the same behaviour over and over again in the hope that they will attain something of material value.
  • Both activities lead to mood modifying experiences and can be both relaxing and exciting.
  • Both activities can result in the person forgetting about time and engaging in the activity for much longer than the person originally intended (because of the escape-like qualities of engaging in the activity).
  • Both activities involve ‘near misses’ that reinforce the behaviour (or as Dr. Binde says “one reel symbol slightly out of place for a jackpot; bites and nibbles of fish that does not get hooked”).
  • Success in either activity may be a combination of skill and chance, and winning or catching a fish give the individuals concerned a sense of achievement and mastery. Furthermore, the person engaging in these activities may not be able to differentiate between what was skill and what was chance (or as Dr. Binde says: “was my choice of bait successful or was it just luck that I caught a big fish?”).
  • In both activities, the ‘availability bias’ comes into play. More specifically, the few big successes (i.e., catching a really big fish or winning a large amount of money) are highly memorable while all the many other occasions when the person lost all their money or caught nothing are easily forgotten.
  • In both activities, superstitious rituals are commonplace (wearing a ‘lucky’ cap, spitting on the lure, etc.). As I noted in a 2005 paper I co-wrote with Carolyn Bingham in the Journal of Gambling Issues, there are certain groups within society who tend to hold more superstitious beliefs than what may be considered the norm including sportsmen, actors, miners, fishermen, and gamblers.
  • In both activities, when things are not going right (i.e., not winning, not catching any fish), the person then tries the same thing somewhere else (a gambler changes table or slot machines, or goes to a new gaming venue; a fisherman changes his bait or tries another place in the river or a new river entirely).
  • In both activities, one win or one fish caught is never enough.
  • Both activities are potentially addictive (“ask either addict’s wife and they will confirm” said Whitney James).
  • In both activities, families forgive the person if they bring something home with them (i.e., winnings or fresh fish).
  • Finally, (and somewhat tongue-in-cheek) both activities (according to Whitney James) “are better with a drink in hand.

Another similarity is that both activities can prove an expensive pastime. While this could be said comparing any two leisure activities, in a 2004 qualitative interview study of seven male high frequency betting shop gamblers published in the journal Addiction Research and Theory, Dr. Tom Ricketts and Ann Macaskill, the gamblers justified the amount spent on gambling by contrasting the amount they spent on other leisure pursuits like fishing. As one gambler said: “Like some people go fishing…and that costs a lot more than what it does with gambling. So that’s the way I see it, really, you pay for your hobbies”.

Another qualitative interview study of seven male online poker players by myself and Dr. Adrian Parke in a 2012 issue of Addiction Research and Theory highlighted that some of the players use fishing analogies to describe their card play. It emerged clearly from one interview that a player could profit in both offline and online forms of gambling by manipulating various forms of information technology. As the authors noted:

“The significance of this belief was moderated in the sense that although participants professed that such profitable control was indeed possible, they indicated that there were also negative consequences of gambling in a controlled and profitable manner. This profitable, yet restricted form of gambling was described by one participant as ‘trawling’, highlighting the demanding and onerous nature of the activity… The use of the term ‘trawling’ for such forms of controlled gambling conveys an impression that is similar to commercial sea fishing (i.e. not only is it an arduous task but also several external factors influence profitability such as luck)”.

Dr. Binde also claimed that it is unsurprising that individuals that want to cease their excessive gambling often find sport fishing a suitable ‘substitution’ leisure activity. He then goes on to argue that fisherman only risk losing time rather than money but then adds:

“Sport fishing gear may cost a bit and fishermen may get the idea that better gear would make fishing more successful. There are people, however, who have problems controlling the extent of their sport fishing and who perceive it as a kind of addiction.

A 2009 online article by R. Pendleton draws similarities between fishing tournaments in Hawaii and poker tournaments. He cites Dr. Marc Miller, a cultural anthropologist and professor at the University of Washington, who theorized that there are four phases of tournament fishing that correspond to those found in gambling.

The first phase is ‘squaring off’, which begins when the anglers board their boat, choose their tackle and the area they intend to fish, and go steaming off to the grounds. It is rather like the gambler with a handful of chips checking out the gaming tables, he noted, but it abruptly ends when the lines hit the water. The second is the determination phase, Miller said. Like the gambler’s blackjack table, this is where the action is. The angler is fishing and fate is in charge. It only ends when the ‘stop fishing’ signal is given. The angler enters the third phase – ‘the disclosure’ – when the fishing is over. Again like the gambler’s hand of cards, it is time for the fisherman to put his catch up for weighing and judging – to finally show what he’s got. Finally comes the ‘settlement phase’ of tournament fishing when the angler’s score is posted and the results are compared with the other fishermen in the contest, rather like when the gambler must settle up with the dealer”.

As far as I am aware, there has never been a study of ‘fishing addiction’ in the psychological literature although there are a few references to it and/or compulsive fishing. Similar to Whitney James’ observation above about wives knowing if their husbands are addicted to fishing or gambling, the 2008 paper by Pollnac and Poggie noted that:

“A commercial crabber from Alaska said, ‘As any fisherman’s wife will tell you, fishing is an addiction. And for commercial fishermen, consider it a gambling addiction’ (Arnold 2006). This is an insightful observation, fishing is like an addiction, and most fishermen would do anything to avoid the potentially painful withdrawal symptoms”.

Bill Glasser, author of the 1976 book Positive Addiction, noted that fishing was one of many ‘positive addictions’ in a later (2012) paper on the topic (in the Canadian Journal of Counselling and Psychotherapy). More specifically, he claimed that he had heard numerous stories from many different individuals claiming they were ‘positively addicted “to a variety of activities such as swimming, hiking, bike riding, yoga, Zen, knitting, crocheting, hunting, fishing, skiing, rowing, playing a musical instrument, singing, dancing, and many more”. Glasser argued that activities such as jogging and transcendental meditation were positive addictions and were the kinds of activity that could be deliberately cultivated to wean addicts away from more harmful and sinister preoccupations. He also asserted that positive addictions must be new rewarding activities that produce increased feelings of self-efficacy.

Glasser’s (1976) own criteria for positive addictions are that the activities must (i) be non-competitive and needing about an hour a day, (ii) be easy, so no mental effort is required, (iii) be easy to be done alone, not dependent on 
people, (iv) be believed to be having some value (physical, 
mental, spiritual), (v) be believed that if persisted in, some improvement will result, and (iv) involve no self-criticism. Although ‘fishing addiction’ arguably meets these criteria, I argued in a 1996 paper in the Journal of Workplace Learning that Glasser’s criteria have little to with accepted criteria for addictive behaviour such as salience, mood modification, tolerance, conflict, withdrawal, loss of control, and relapse. Therefore, although Glasser believes that addiction to fishing is a positive addiction, I would argue that ‘fishing addiction’ using Glasser’s criteria is not really an addiction.

In an online article on ‘The psychology of fishing addiction’ (In The Bite, 2014), addiction psychotherapist Alexandria Stark asserted that although fishing addiction was not recognized in the psychiatric community, the American Psychiatric Association’s criteria of Gambling Disorder in the DSM-5 could be adapted to screen for whether someone is a fishing addict. Additionally, a 2007 paper in the journal Parkinsonism and Related Disorders by Dr. Andrew McKeon and colleagues reported seven case studies of “unusual compulsive behaviors following treatment for Parkinson’s disease with dopamine agonist therapy. One of the seven cases was a 48-year-old man who had been diagnosed with Parkinson’s disease at the age of 43 years and was taking daily doses of levodopa [300mg], ropinirole [24mg] and selegeline [5mg]. It was reported that the man suddenly “developed an intense interest and fascination with fishing” even though he had little prior interest in the activity. His wife reported that her husband was fishing incessantly for day after day, and that even though he caught nothing his interest in fishing did not diminish.

Pollnac and Poggie who have carried out lots of research into professional fisherman have speculated that professional fisherman and gamblers may have similar personality types and similar biological pre-dispositions. They speculated that if professional fisherman had not had gone into the fishing profession, they may have ended up as drug addicts or gambling addicts. More specifically, they noted that:

The possible existence of a genetic component related to an active, adventurous, aggressive, and courageous personality type should not be surprising. Fishermen manifesting this personality type are more successful as would be the hunters and gatherers who provided sustenance for human populations through most of the time humans have been on earth. This genetic component, which would have been advantageous for early humans, served us well, but when it was no longer needed, its frequency in human populations probably started a slow decline. It still exists, however, and those lucky (or unfortunate) to have it have to find other outlets for their need for novelty and adventure – risky sports and high stakes gambling, recreational hunting, marine sport fishing, and risky jobs like firefighting, policing, futures trading in the stock market, etc. Those who do not find other outlets or who may be misguided turn to self destructive behavior such as addictive gambling, crime (high risk) and substance abuse (LeGrand et al. 2005). Fortunately for fishermen, the occupation of fishing, a risky occupation, can provide a certain level of adventure accompanied by various risks and hence, serve as a socially acceptable outlet for their need for action and adventure while increasing their levels of satisfaction and happiness”.

In our just published paper, we visited various online discussion forums dedicated to fishing (e.g., Big Fish Tackle [www.bigfishtackle.com] and Angling Addicts [http://www.anglingaddicts.co.uk]) and located a number of fishermen that claimed their fishing was an addiction and/or had addiction-like properties (a selection of self-reports that we found are published in the paper). We argued that these self-reports have existential value and provide informal data that could be more formally investigated in future studies. In one of our cases, the individual was totally preoccupied by fishing even though he was not fishing every day (in fact, twice a week maximum). He thought about fishing all the time and it appeared to be the single most important thing in his life. If he couldn’t actually fish he was watching online fishing videos, watching fishing television programmes, playing fishing videogames, or on online fishing forums. Here, the individual appeared to display cross-tolerance (i.e., when unable to fish he engaged in other fish-related activities such as playing a fishing videogame). The only activity that made him want to get out of bed was fishing. The description of his behaviour is arguably one of the best working definitions of salience that you could find. For want of a better word, he was totally obsessed with fishing.

In another case, fishing was actually described by the individual as an addiction and that his wife made him cut back on his fishing. The way he overcame his urge to fish was to get a job that involved fishing which not only met his fishing needs but resolved the conflict in his relationship as his wife no longer cared that he was fishing every day when it became his full-time job. In another case, the individual described withdrawal symptoms if he was unable to fish and that he got “the shakes” if he was unable to fish, similar to an alcoholic who gets the shakes (i.e., delirium tremens) when unable to drink. Another case specifically described fishing in extreme cases as an addiction and something that has been with him (and will be with him) for life.

A further case described fishing as an addiction and how he first got involved with fishing (i.e., being in Florida near water meant that fishing excursions were readily and easily available). He provided an example of relapse in that he had been able to give up fishing for a period in his life (because there was no opportunity for his to fish), only for it to return at a later point. Another case likened fishing to drug use and that once someone had tried fishing they have to go back for more. For want of a better word they become ‘hooked’ (no pun intended but another linguistic example of the association between fishing and addiction).

One individual described how he was given an ultimatum by his wife, and as a consequence, he chose fishing over the relationship. Obviously his fishing was causing relationship problems and when it came to make a decision, he decided he loved fishing more than his wife and can now fish whenever he wants without his ex-wife interfering or passing negative comment on his desire to fish. By removing his wife from his day-to-day activity, the fishing presumably became a non-problematic behaviour. Another individual described fishing as an activity that has become constant in his life and was not just a phase that they are going through.

In a nutshell, our paper attempted to examine whether – in extreme cases – fishing could be characterised as an addiction, and also attempted to argue that there are many commonalities between excessive fishing and another behavioural addiction (i.e., gambling addiction). It does appear to have addiction-like properties and that some fishers describe their fixation on fishing as an addiction akin to problematic drug use and/or gambling. However, our paper didn’t argue that fishing addiction exists, just that some people (including fishers themselves) conceptualise their excessive behaviour as an addiction and that a few scholars have asserted that in extreme cases, fishing may be a behaviour that can be potentially addictive.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Arnold, C. 2006. A crabbers’ life. National Fisherman 87, 6, 22-25.

Binde, P. (2013). Fishing and gambling. The Anthropology of Gambling, August 31. Retrieved August 1, 2016, from: http://ongambling.org/fishing-and-gambling (last accessed May 15, 2015)

Glasser, W. (1976), Positive Addictions. New York, NY: Harper & Row.

Glasser, W. (2012). Promoting client strength through positive addiction. Canadian Journal of Counselling and Psychotherapy, 11(4), 173-175.

Griffiths, M.D. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8(3), 19-25.

Griffiths, M.D.  (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Griffiths, M.D. & Auer, M. (2019). Becoming hooked? Angling, gambling, and ‘fishing addiction’. Archives of Behavioral Addiction, 1(1), .

Griffiths, M.D. & Bingham, C. (2005). A study of superstitious beliefs among bingo players. Journal of Gambling Issues, 13. Retrieved August 1, 2016, from http://jgi.camh.net/doi/full/10.4309/jgi.2005.13.7 (last accessed May 15, 2015)

In The Bite (2014). The psychology of fishing addiction. July 15. Retrieved August 1, 2016, from: http://www.inthebite.com/2014/07/the-psychology-of-fishing-addiction/ (last accessed May 15, 2015)

James, W. (2013). 8 reasons fishing is like gambling. Handwritten [Personal Blog]. Retrieved August 1, 2016, from http://whitneyljames.tumblr.com/post/52146316443/8-reasons-fishing-is-like-gambling (last accessed May 15, 2015)

McKeon, A., Josephs, K. A., Klos, K. J., Hecksel, K., Bower, J. H., Michael Bostwick, J., & Eric Ahlskog, J. (2007). Unusual compulsive behaviors primarily related to dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Parkinsonism and Related Disorders, 13(8), 516-519.

Parke, A., & Griffiths, M. (2012). Beyond illusion of control: An interpretative phenomenological analysis of gambling in the context of information technology. Addiction Research and Theory, 20(3), 250-260

Pendleton, R. (2009). Fishing is Hawaii’s legalized gambling. The Examiner, April 29. Retrieved August 1, 2016, from http://www.examiner.com/article/fishing-is-hawaii-s-legalized-gambling

Pollnac, R. B., Monnereau, I., Poggie, J. J., Ruiz, V., & Westwood, A. D. (2011). Stress and the occupation of fishing. In Langan-Fox, J. & Cooper, C.L. Handbook of Stress in the Occupations, 309-321. Cheltenham: Edward Elgar Publishing Ltd.

Pollnac, R. B., & Poggie, J. J. (2008). Happiness, well-being, and psychocultural adaptation to the stresses associated with marine fishing. Human Ecology Review, 15(2), 194

Prattis, J. I. (1973). Gambling, fishing and innovation – a cross situational study of decision making. International Journal of Comparative Sociology, 14(1-2), 76-88.

Ricketts, T., & Macaskill, A. (2004). Differentiating normal and problem gambling: A grounded theory approach. Addiction Research & Theory, 12(1), 77-87.

Smith, G. J., Wynne, H. J., & Hartnagel, T. F. (2003). Examining police records to assess gambling impacts: A study of gambling-related crime in the City of Edmonton. Edmonton: Alberta Gaming Research Institute

Strange fascinations: A brief look at unusual compulsive and addictive behaviours

In previous blogs, I have examined lots of strange types of addictive and compulsive behaviours including compulsive singing, compulsive hoarding, carrot eating addiction, Argentine tango addiction, compulsive nose-picking, compulsive punning, compulsive helping, obsessive teeth whitening, compulsive list-making, chewing gum addiction, hair dryer addictionwealth addiction, and Google Glass addiction (to name just a few).

However, while doing some research for a paper I am writing on ‘fishing addiction’ (yes, honestly), I came across an interesting paper on unusual compulsive behaviours caused by individuals receiving medication for Parkinson’s disease ([PD] a degenerative disorder of the central nervous system) and multiple system atrophy ([MSA] a degenerative neurological disorder in which nerve cells inside the brain start to degenerate and with symptoms similar to Parkinson’s disease).

In the gambling studies field there are now numerous papers that have been published showing that some Parkinson’s patients develop compulsive gambling after being treated for PD. According to the Parkinsons.co.uk website, those undergoing PD treatment can have many side effects including addictive gambling, obsessive shopping, binge eating, and hypersexuality. The website also notes other types of compulsive behaviour that have been associated with PD medication including “punding or compulsive hobbyism [when someone does things such as collecting, sorting or continually handling objects]. It may also be experienced as (i) a deep fascination with taking technical equipment apart without always knowing how to put it back together again, (ii) hoarding things, (iii) pointless driving or walking, and (iv) talking in long monologues without any real content”.

The paper that caught my eye was published in a 2007 issue of the journal Parkinsonism and Related Disorders by Dr. Andrew McKeon and his colleagues. They reported seven case studies of unusual compulsive behaviours after treating their patients with dopamine agonist therapy (i.e., treatment that activates dopamine receptors in the body). The paper described some compulsive behaviours that most people would not necessarily associate with being problematic. Below is a brief description of the seven cases that I have taken verbatim from the paper.

  • Patient 1: “A 65-year-old female with PD for 9 years developed compulsive eating, and also felt compelled to repetitively weigh herself at frequent intervals during the day and at night. She found her behavior both purposeless and repetitive. Obsessive thoughts were also a feature, as the patient ‘had to’ weigh herself three times each occasion she used the weighing scales”.
  • Patient 2: “A 67-year-old female with PD for 8 years played computer games and solitaire card games for hours on end, often continuing to do so through the night. She did not enjoy the experience and found it purposeless, but did so as she felt she had ‘to be doing something’. She also developed compulsive eating and gambling”.
  • Patient 3: “A 48-year-old male with PD for 5 years, with little prior interest, developed an intense interest and fascination with fishing. His wife was concerned that he fished incessantly for days on end, and his interest did not abate despite never catching anything. This patient also developed compulsive shopping, spending large amounts of time and money in thrift stores”.
  • Patient 4: “A 53-year-old male with PD for 13 years became intensely interested in lawn care. He would use a machine to blow leaves for 6h without rest, finding it difficult to disengage from the activity, as he found the repetitive behavior soothing. He also developed compulsive gambling”.
  • Patient 5: “The wife of a 52-year-old male with an 11-year history of PD complained that her husband now spent all of his time on his hobbies, to the detriment of their marriage. The patient made small stained glass windows, day and night. In addition, he would frequently stay awake arranging rocks into piles in their yard, intending to build a wall, but never doing so. He would start multiple projects but complete nothing. He was also noted to have become hypersexual, demanding sexual intercourse from his wife several times daily”.
  • Patient 6: “This 60-year-old male, with a history of alcohol abuse and ultimately diagnosed with MSA, relentlessly watched the clock, locked and unlocked doors and continually arranged and lined up small objects on his desk. He also became hyperphagic and hypersexual, developing an intense fascination with pornographic films”.
  • Patient 7: “The wife of a 59-year-old male with PD for 1 year described how her husband dressed and undressed several times daily. On one occasion, while guests were at their house for dinner, he spent most of his time in his bedroom repeatedly changing from one pair of trousers into another. This behavior deteriorated considerably on increasing levodopa dose to 1100mg/day, and on a subsequent occasion after reducing quetiapine from 100 to 75 mg/day”.

These cases highlight that the compulsive behaviours that develop following dopamine agonist therapy often co-occur with one or more other compulsive behaviour and that much of these behaviours are repetitive and unwanted. As the authors noted:

“The temporal association between medication initiation and the onset of these behaviors led to our suspicion that medications were causative. In the aggregate, these patients illustrate that the behaviors provoked by drug therapy in parkinsonism cover a broad spectrum, ranging from purposeless and repetitive to complex, reward-oriented behaviors. Punding is the term typically applied to the former, and was seen in Patient 5 (arranging rocks into piles) and Patient 6 (lining up small objects on a desk)…Previous descriptions of pathological behaviors occur- ring with dopaminergic therapy in PD have been notable for the absence of obsessive thoughts accompanying compulsive behaviors, unlike Patient 1 who was remark- able for a counting ritual accompanying repetitive use of a weighing scale. In six of the seven cases, other reward- seeking behaviors (gambling, shopping, hypersexuality or overeating) were present and contemporaneous with these other unusual compulsive behaviors. This suggests that all of these behaviors, while phenomenologically distinct, are all part of the range of psychopathology encapsulated by obsessive-compulsive spectrum disorders”.

According to the Parkinsons.co.uk website, PD sufferers are more likely to experience impulsive and compulsive behaviour if the person is (i) diagnosed with Parkinson’s at a young age, (ii) male, (iii) single and live alone, (iv) a smoker, and (v) someone with a personal or family history of addictive behaviour. The same article also notes that if the PD sufferer has a history of ‘risk-taking’, such as gambling, drug abuse or alcoholism, [they] may be more likely to develop dopamine addiction”. This is where the PD sufferer takes more of their medication than is needed to control their Parkinson’s symptoms (and known as dopamine dysregulation syndrome). Similarly, Dr. McKeon and colleagues concluded:

“Previously described associated clinical features include a prior history of depressed mood (four patients in this series), disinhibition, irritability and appetite disturbance…A history of problems with impulse control prior to the diagnosis of PD may be a risk factor for developing compulsive behaviors with dopaminergic therapies…although this only pertained to Patient 6…The compulsions were not found to be troublesome by three patients, with complaints regarding behavioral change coming from the patient’s spouse. Our observations affirm the need to check with both patient and family at follow-up visits for the emergence of a variety of troublesome pathological behaviors that may result from dopaminergic therapy, particularly dopamine agonists”.

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Dodd, M. L., Klos, K. J., Bower, J. H., Geda, Y. E., Josephs, K. A., & Ahlskog, J. E. (2005). Pathological gambling caused by drugs used to treat Parkinson disease. Archives of Neurology, 62, 1377-1381.

Griffiths, M.D. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8(3), 19-25.

Griffiths, M.D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Klos, K. J., Bower, J. H., Josephs, K. A., Matsumoto, J. Y., & Ahlskog, J. E. (2005). Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Parkinsonism and Related Disorders, 11, 381-386.

McKeon, A., Josephs, K. A., Klos, K. J., Hecksel, K., Bower, J. H., Michael Bostwick, J., & Eric Ahlskog, J. (2007). Unusual compulsive behaviors primarily related to dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Parkinsonism and Related Disorders, 13(8), 516-519.

Nirenberg, M. J., & Waters, C. (2006). Compulsive eating and weight gain related to dopamine agonist use. Movement Disorders, 21, 524-529.

Pontone, G., Williams, J. R., Bassett, S. S., & Marsh, L. (2006). Clinical features associated with impulse control disorders in Parkinson disease. Neurology, 67, 1258-1261.

Voon, V., Hassan, K., Zurowski, M., De Souza, M., Thomsen, T., Fox, S.,…& Miyasaki, J. (2006). Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology, 67, 1254-1257.