Current Advances in Behavioral Addictions: From Fundamental Research to Clinical Practice
Abstract
Gambling disorder is the only behavioral addiction recognized as a clinical disorder in DSM-5, and Internet gaming disorder is included as a condition requiring further research. ICD-11 categorizes gambling and gaming disorders as disorders due to addictive behaviors. Additional behavioral addictions may include compulsive sexual behavior disorder, compulsive buying-shopping disorder, and problematic use of social media. This narrative review summarizes the current state of knowledge regarding these five (potential) disorders due to addictive behaviors. All five (potential) disorders are clinically relevant and prevalent. Behavioral addictions frequently co-occur with other mental and behavioral problems, such as depression, anxiety, and attention deficit hyperactivity disorder. Validated diagnostic instruments exist, with empirical support varying across conditions. No medications have approved indications from regulatory bodies for behavioral addictions, and cognitive-behavioral therapy has the most empirical support for efficacious treatment. Given that behavioral addictions are prevalent, frequently co-occur with psychiatric disorders, may often go undiagnosed and untreated, and have been linked to poorer treatment outcomes, active screening and treatment are indicated. Public health considerations should be expanded, and impacts of modern technologies should be investigated more intensively. Treatment optimization involving pharmacotherapy, psychotherapy, neuromodulation, and their combination warrants additional investigation.
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Published In
American Journal of Psychiatry
History
Received: 29 January 2024
Revision received: 10 February 2024
Accepted: 27 February 2024
Published online: 11 December 2024
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Competing Interests
Drs. Brand, Demetrovics, King, Müller, and Potenza are board members of the International Society for the Study of Behavioral Addictions. Dr. Demetrovics’s university (ELTE Eötvös Loránd University) receives funding from Szerencsejáték Ltd. (the gambling operator of the Hungarian government) to maintain a telephone helpline service for problematic gambling, and his other university (University of Gibraltar) receives funding from the Gibraltar Gambling Care Foundation and donations from gambling operators through the LCCP RET process supervised by the UK Gambling Commission. Dr. Fineberg has held research or networking grants from the National Institute for Health and Care Research, COST Action, the EU, UK Research and Innovation, and Orchard; she has received travel and/or hospitality expense coverage from the British Association for Psychopharmacology, the European College of Neuropsychopharmacology, the Royal College of Psychiatrists, the International College of Neuropsychopharmacology, the International Forum of Mood and Anxiety Disorders, and the World Psychiatric Association; she has received payment from Elsevier for editorial duties and the Mental Health Academy and Children and Screens for lecturing; she leads an NHS treatment service for OCD; she is a board member for various registered charities linked to OCD; she provides expert advice on psychopharmacology to the Medicines and Healthcare Products Regulatory Agency; and she has participated in a WHO working group focusing on diagnosis and classification of obsessive-compulsive or related disorders for ICD-11. Dr. Potenza has served as a consultant for the Addiction Policy Forum, AXA, BariaTek, Game Day Data, Idorsia Pharmaceuticals, and Opiant Therapeutics and has served as a consultant and/or adviser for gambling, health care, nonprofit, and legal entities on issues related to impulse control, Internet use, and/or addictive disorders; he has been involved in a patent application with Yale University and Novartis; he has received research support from Children and Screens, the Connecticut Council on Problem Gambling, and Mohegan Sun Casino; and he has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse control disorders, and other health topics. All of the authors have performed grant reviews for research funding agencies, and/or edited journals or journal sections, and/or given academic lectures in clinical or scientific venues, and/or produced book chapters for publishers of mental health texts.
Funding Information
The authors did not receive direct funding specifically for this research. The work of Drs. Brand, Antons, Müller, and Wegmann on this article was carried out in the context of the Research Unit ACSID, FOR2974, funded by the Deutsche Forschungsgemeinschaft (German Research Foundation; 411232260). Dr. Demetrovics’s contribution was carried out in the context of funding from the Hungarian National Research, Development, and Innovation Office (KKP126835). The work of Dr. Fineberg was carried out in the context of the BootStRaP project, grant 10108238, funded by the EU. The work of Dr. Jimenez-Murcia on this article was carried out in the context of the grants from the Delegación del Gobierno para el Plan Nacional sobre Drogas (2021I031), Ministerio de Ciencia e Innovación (PDI2021-124887OB-I00), and co-funded by FEDER funds/European Regional Development Fund. The work of Dr. Mestre-Bach on this article was carried out in the context of project ITEI B23-010 from the Universidad Internacional de La Rioja and project SUBV23/00024 from the Ministerio de Consumo. The work of Dr. Moretta on this article was carried out in the context of research activities as assistant professor of the Department of General Psychology, University of Padova. The work of Dr. Potenza on this article was carried out in the context of NIH grant RF1 MH128614.
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