Journal of Behavioral Addictions最新文献

The concept of 'internet addiction' was introduced in the 1990s and has increasingly been recognized as a clinical and public health issue. Although umbrella terms can be useful for screening, theoretical considerations, and intervention planning, the term itself has received criticism because of its conceptual heterogeneity, implying an addiction to a medium and not including a wide range of problematic behavioral patterns that are below the diagnostic threshold of a clinical disorder. To address this criticism, we propose adopting the term 'problematic use' instead of 'addiction'. Furthermore, we argue that while 'problematic usage of the internet' is currently a useful umbrella term, recent technological advancements and increasing online presence may in the future require a conceptual and methodological shift in terminology from 'internet' to the more specific 'screen-based devices' or 'screens' that would enable more accurate assessment and intervention strategies. Terms focusing on specific devices, such as 'smartphone addiction,' should also be used with caution, as problematic use relates to applications rather than the hardware itself and may extend to various devices.

Background and aims: Gambling disorder (GD) presents significant psychological, financial, and social consequences. Mindfulness-based interventions (MBIs) have emerged as promising adjunctive treatments. However, the evidence base remains heterogeneous. The present systematic review evaluated the current empirical literature on MBIs for GD, focusing on their efficacy, methodological quality, and limitations.

Methods: Scopus, PubMed, Web of Science, EBSCO, and PsycINFO were searched for English-language studies published between 2012 and April 2025. The final sample comprised 12 studies: five randomized controlled trials, one controlled pilot study, two repeated-measures studies, one mixed-methods study, and three single-group pretest-posttest studies. A narrative synthesis evaluated MBI impacts.

Results: MBIs consistently reduced gambling frequency and cravings while enhancing psychological outcomes. Studies combining mindfulness with cognitive behavioral therapy showed significant declines in problem gambling behavior. Psychological distress and cravings also decreased notably across interventions. The mindfulness components employed varied in focus and application, adding nuance to outcome interpretation. However, it remains unclear to what extent the observed effects can be attributed to mindfulness-specific mechanisms.

Discussion and conclusions: MBIs show promise as a complementary treatment for gambling disorders, although small sample sizes and methodological limitations suggest a need for more robust research.

Since the recognition of internet gaming disorder (IGD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and gaming disorder (GD) in the eleventh revision of the International Classification of Diseases, significant progress has been made toward standardizing assessment practices. However, the present paper argues that three key lessons can be derived when considering the advancements in the field over the past decade. Firstly, rather than developing additional instruments, the field would greatly benefit from unifying existing assessment frameworks and establishing a clinical 'gold standard' based on current diagnostic criteria. Secondly, continued development of psychometric assessment alone is insufficient because the field urgently needs a robust theoretical framework that is able to distinguish between excessive and disordered gaming effectively. Without sound a theory, assessment and treatment practices risk ongoing conceptual drift and fragmentation. Finally, despite recent criticisms regarding the use of psychometric instruments and self-report measures, these methodologies remain necessary. While more objective gaming data can be valuable, they also present with important limitations that need to be fully considered. A potential way forward for an effective assessment approach may involve combining both psychometrically robust self-report data with objective data. However, future research must still ensure that assessment instruments undergo rigorous psychometric validation beyond reliability and validity alone. The paper concludes that instead of prioritizing the development of new assessment tools, the field would benefit more from strengthening its theoretical foundation and rigorously evaluating existing diagnostic frameworks and psychometric instruments.

Behavioral addictions, including problematic internet use, gaming, and gambling, are emerging as significant public health concerns in Africa, driven by rapid digitalization and socioeconomic shifts. This commentary provides a critical overview of the current state of behavioral addictions in Africa, examining prevalence, cultural influences, and systemic barriers to research and intervention. Despite growing evidence of harm, particularly among youth, the continent faces significant challenges, including limited epidemiological data, cultural biases in assessment tools, and an underdeveloped mental health infrastructure. Drawing on regional studies and global frameworks, the need for culturally sensitive research, evidence-based interventions, and robust policy frameworks is highlighted. The paradoxical coexistence of rising addiction risks and minimal regulatory oversight underscores the urgency of addressing behavioral addictions in African contexts.

Background and aims: Service use data among patients with gambling disorder (GD) remains scarce. This exploratory study aimed to identify the service use profiles associated with social and health conditions, gambling games or chronicity (≥ 5 years), and subsequent adverse outcomes.

Methods: In 2012-2013, 2,311 patients (72% men, 45 years [SD: 13.60]) were recruited from addiction treatment centers in Quebec (Canada); their administrative data were merged with provincial health and education data (1979-2022). Latent class analysis identified profiles related to GD treatment received (2009-2021) and other service use in the 12 months before index date (last GD records). Multiple multinomial logistic and Cox regressions examined associations with patient conditions and subsequent outcomes over 12 months (acute care, suicidal behaviors, death).

Results: Profile 2 patients (35% of sample) exhibited the most chronic GD, and high use of GD and other services. Profile 4 (20%) reported the worst social and health conditions, received no GD treatment, and showed moderate use of other services. Profile 1 (15%) included patients with the best conditions, but moderate GD treatment and low use of other services. Mostly composed of patients aged 35+ years, Profile 3 (30%) received low GD treatment but high general practitioner care. Patients in Profiles 4 and 2 reported the worst conditions and highest rates of adverse outcomes - although Profile 2 received the best care overall.

Conclusion: GD treatment and other care may be strengthened and better coordinated. Screening, motivational interventions, and referrals to care could be consolidated. Profiles 4 and 2 may benefit from more long-term care.

Background and aims: Problematic gaming has been linked to increased levels of psychotic-like experiences (PLEs) in youth, but the role of environmental factors remains unclear. We aimed to examine the association of problematic gaming with PLEs and, using affordance theory, to evaluate whether environmental factors could help enhance the identification of this risk.

Methods: Participants were 6,467 youth (39.2% female) who reported playing digital games, from the Adolescent Brain Cognitive Development Study in the U.S. Measures included problematic gaming, peer environment (number of close friends), school environment (teachers, activities, etc.), family environment (parental monitoring), and PLEs. We examined whether the peer, school, and family environments at age 12 were associated with problematic gaming and moderated its association with PLEs at age 13.

Results: Higher levels of problematic gaming at age 12 were associated with higher levels of PLEs at age 13, independently of sociodemographic variables and previous PLEs. The strength of the association between problematic gaming and PLEs did not significantly vary as a function of the peer, school, or family environment variables (i.e., there was no significant interaction effect). However, more protective school and family environments at age 12 were associated with lower levels of problematic gaming at age 13, independently of previous levels of problematic gaming.

Discussion and conclusions: Positive school and family environments may be protective against problematic gaming in adolescence but do not appear to attenuate the putative effect of problematic gaming on PLEs. The results provide partial support to an affordance-based conceptualization of problematic gaming.

Background and aims: Moments of impaired control are common in problematic gaming and pornography use. Previous research has mostly focused on general self-control deficits in laboratory or cross-sectional settings. As a novel approach, we examined craving and inhibitory control in daily life as dual mechanisms of moments of impaired control in the natural environment by combining laboratory tasks with ecological momentary assessment (EMA).

Methods: In this pre-registered study, 118 participants (M = 26.16 years, SD = 7.72 years, 75 males, 42 females, 1 divers) with nonproblematic, risky or pathological pornography use or gaming (ngaming = 74, npornography = 44) based on a standardized diagnostic interview, completed a cue-reactivity paradigm, craving assessments, Stop-Signal Task, and seven days EMA of craving, behavior-specific inhibitory control, and moments of impaired control (July 2023-July 2025).

Results: Average frequency of moments of impaired control was predicted by average craving intensity in real life. Intraindividual likelihood of experiencing a moment of impaired control was predicted by reduced behavior-specific inhibitory control in real life. Laboratory craving predicted real-life craving intensity which was linked to real-life behavior specific inhibitory control ratings. Findings generalized across both behavior groups.

Discussion and conclusions: Craving emerged as an overall (between-person) risk factor, whereas behavior-specific inhibitory control as a situation-specific (within-person) mechanism in moments of impaired control in potentially addictive gaming or pornography use. Prevention, treatment, and future research should address within versus between-person processes and continue combining laboratory tasks with EMA to clarify how lab-indexed mechanisms translate into real-world impaired control.

This commentary critically considers the case for including non-digital gaming within the scope of gaming disorder. The ICD-11 category for gaming disorder refers to gaming (i.e., 'digital gaming' or 'video-gaming') which may be predominantly 'online' (i.e., over the internet) versus 'offline'. Non-digital forms of gaming (i.e., gaming that does not involve any electronic devices and is not conducted over the internet) are not explicitly recognized. We suggest that gaming in both digital and non-digital formats is an activity of relevance to addiction studies and public health, and that an exclusive focus on digital gaming may overlook potential non-digital game-related risks and harms. We refer to popular collectible card games (e.g., Pokémon, Magic: The Gathering [MtG]) and tabletop games (e.g., Warhammer 40K), as these activities seem to have the most in common with online games, particularly in relation to similarities to digital monetization schemes (e.g., loot boxes). We call for research to investigate the relative costs and benefits of engagement in non-digital gaming activities. If highly involved players of non-digital games tend to not report gaming disorder symptoms or harm, then it may be worthwhile examining how these players differ from digital game players. Finally, investigating non-digital gaming may produce new insights into developing effective interventions and preventive measures for problematic digital gaming.

Background: Despite the rapid growth in gaming consumption and associated harms in adolescents, data-driven research to identify brain networks underlying problematic gaming remains limited. This study aimed to identify neural networks predictive of problematic-gaming severity in youth using connectome-based predictive modelling (CPM), a machine-learning approach that employs whole-brain functional connectivity data.

Methods: From the Adolescent Brain Cognitive Development study at the two-year follow-up, 1,036 participants (Mage = 12.0, 60.7% male) were studied. CPM with 10-fold cross-validation was applied to problematic-gaming scores and functional magnetic resonance imaging (fMRI) data collected during the performance of a reward-processing task. To determine generalizability, additional CPM analyses were performed using other task-based (e.g., those relevant to response inhibition, emotion regulation, and working memory) and resting-state fMRI data.

Results: CPM successfully predicted problematic-gaming scores (r = 0.12, p = 0.002). Predictive networks involved several connections within and between canonical networks implicated in visual processing (visual area 2 and visual association networks), cognitive control and executive functioning (frontoparietal and medial frontal networks), and relevance and motor response (salience and sensorimotor networks). CPM predicted problematic-gaming scores across all analyzed brain states and found shared predictive canonical networks, indicating generalizability. Applying the final reward-processing model to other task-based and resting-state fMRI data also successfully predicted problematic-gaming severity.

Conclusions: The identified large-scale networks predictive of problematic-gaming severity in adolescents may serve as promising targets for personalized and novel interventions. Before using these results to guide clinical advances, future research should use external samples to evaluate replicability of the identified network.

Background and aims: Problematic pornography use (PPU) has been associated with impaired risk-based decision-making, possibly stemming from disrupted feedback processing. However, the underlying cognitive and neural mechanisms remain unclear. This study examined behavioral risk-taking and feedback-related electrophysiological responses in individuals at risk for PPU.

Methods: Thirty-five male university students at risk for PPU (M = 20.51, SD = 0.89) and thirty-four matched controls (M = 20.79, SD = 1.70) completed the Balloon Analogue Risk Task (BART) while EEG data were recorded. Self-report questionnaires assessing impulsivity traits were also administered.

Results: At the behavioral level, individuals in the PPU risk group exhibited significantly more balloon explosions and lower total earnings than controls, while no group difference was found in the adjusted number of pumps. At the neural level, there were no group differences in the feedback-related negativity (FRN), suggesting intact early evaluation of feedback valence. However, the PPU risk group exhibited significantly reduced P300 amplitudes in response to negative (loss) feedback, suggesting impaired attentional allocation and feedback integration, which may reflect a diminished capacity to adapt behavior based on aversive outcomes. Furthermore, individuals at risk for PPU reported elevated levels of impulsivity, particularly in emotion-driven components such as positive and negative urgency.

Conclusion: This neurocognitive profile may contribute to the persistence of maladaptive behaviors despite adverse consequences and highlights potential intervention targets to improve feedback sensitivity and self-regulation in individuals with PPU.