Journal of Behavioral Addictions最新文献

Background: Internet Gaming Disorder (IGD) and Gaming Disorder (GD) have emerged as significant public health concerns, with studies highlighting their association with substance use. Research on IGD/GD faces challenges due to heterogeneous definitions and measurement tools. While the introduction of DSM-5 and ICD-11 criteria for these behaviors improved research consistency, substance use patterns in individuals with IGD/GD, when defined strictly by these criteria, remain unexplored. Importantly, a comprehensive review of substance use patterns among individuals with IGD/GD based on DSM-5 and ICD-11 criteria has never been conducted.

Objective: This scoping review aims to map existing literature on substance use in individuals with IGD/GD, focusing on patterns, underlying mechanisms, and moderating factors influencing this relationship.

Methods: The review adhered to the JBI manual for scoping reviews and PRISMA-ScR standards. A literature search was conducted in August 2025, in seven bibliographic databases, supplemented by citation tracking strategies. Inclusion criteria encompassed empirical studies published post-2013, using scales published after 2013, based on DSM-5/ICD-11 criteria for IGD/GD, and focusing on substance use.

Results: A total of 36 studies out of 5,561 identified, predominantly cross-sectional, were included. Findings indicated a high co-occurrence of IGD/GD and substance use, particularly among adolescents and young adults. Shared risk factors such as impulsivity, sensation-seeking, and maladaptive coping strategies were identified. Alcohol, tobacco, stimulants, and cannabis emerged as the most commonly used substances, with variations across cultural contexts. Limited longitudinal data underscored the need for research on the progression and interaction of IGD/GD and substance use over time.

Conclusion: The findings revealed that individuals with IGD/GD frequently engage in substance use, including alcohol, tobacco, cannabis, and stimulants such as amphetamines. This review highlights critical mechanisms linking IGD/GD and substance use, emphasizing the role of behavioral reinforcement and emotional dysregulation. Future research should focus on longitudinal designs and protective factors to inform tailored prevention and intervention strategies. Systematic screening for substance use is warranted among individuals with IGD/GD.

Background and aims: Most men consume pornography, with a small but significant percentage losing control over their use. Since ICD-11, problematic pornography use can be diagnosed as "compulsive sexual behavior disorder." Debate persists on whether problematic pornography use is an impulse-control disorder or a behavioral addiction. Mechanisms of learning and memory play a central role in addictive disorders but are presumably less relevant for impulse control disorders.

Methods: One hundred thirty-nine heterosexual male users of pornography and gaming participated in our study which was part of a multi-center research project on internet use disorders in Germany. We focus on a subsample of fifty-eight non-problematic (n = 35) and problematic pornography users (n = 23, labeled pathological). FMRI data were collected during appetitive conditioning, extinction and recall. Pornographic, game, and money images served as unconditioned stimuli, geometric shapes as conditioned stimuli (CS).

Results: During appetitive conditioning pathological pornography users showed a generally stronger response in ventral striatum to all CSs, whereas altered activations in extinction and recall were specific to the porn-associated CS. Greater activations in the dorsal anterior cingulate cortex during extinction and in the medial orbitofrontal cortex during recall suggest persistence of appetitive memory for pornography in pathological users, supported by valence ratings and skin conductance responses (SCR). Sensitization to the monetary cue also emerged in SCR.

Discussion and conclusions: Based on these new neurobiological findings, which are consistent with current addiction theories about stimulus-specific altered reward sensitivity and appetitive memory, we argue that problematic pornography use should be considered a behavioral addiction.

Purpose: This study applied the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and the Relational Development System Theory (RDS) to identify key individual and contextual correlates of adolescents' problematic Internet use (PIU) with machine learning approaches.

Methods: Data from 68,425 adolescents were analyzed using five ensemble models (AdaBoost, Random Forest, LightGBM, Bagging, CatBoost) within a nested cross-validation framework. Key factors were identified through SHapley Additive exPlanations (SHAP), while bivariate partial dependence analyses were used to identify interactions.

Results: The prevalence of PIU risk was 23.2%. Five algorithms achieved comparable performance. CatBoost achieved the best performance and was selected as the final predictive model. SHAP values showed that the top 17 features explained nearly 80% of the model. At the individual level, intolerance of uncertainty was the strongest risk factor, whereas mindfulness was the main protective factor. Additionally, weekend video game time was a major behavioral risk contributor. At the contextual level, home-leaving intentions and bullying perpetration were identified as key family- and peer-related risk factors, respectively. Bivariate partial dependence analyses found both within-individual (e.g., mindfulness * intolerance of uncertainty) and individual-contextual (e.g., mindfulness * home-leaving intentions) interaction effects.

Conclusions: This study applied five machine learning algorithms to identify key individual and contextual factors associated with adolescent PIU risk and their interactions. The results suggest that risk factors accumulate across systems and impair adolescents' adaptive capacity, whereas mindfulness exerts cross-system effects that buffer these risks, offering implications for targeted interventions.

Background and aims: Gambling advertising during sports broadcasts has received increasing academic attention, although research has primarily focused on the United Kingdom context. This study addresses this geographical limitation by conducting a comprehensive content analysis of gambling advertising during football broadcasts in the Czech Republic. The specific objectives were to examine the frequency, nature, and characteristics of gambling advertisements in coverage of Czech football matches.

Methods: A content analysis was conducted across four rounds of the Czech First Football League, encompassing 32 matches during August-September 2025. Two coders analysed 16 matches each following the establishment of high inter-rater reliability. All advertisements appearing during broadcasts were systematically recorded, documenting frequency, duration, timing, product types, and promotional characteristics.

Results: A total of 1,824 gambling advertisements were documented across 32 matches, averaging 57 advertisements per match (SD = 7.04). The total advertising duration was 22,011 s (6.1 h), with an average of 11.5 min per match. Sports betting dominated (85.0%), followed by online casino promotions (10.7%) and lottery advertisements (4.3%). During live match coverage, 700 advertisements from a single title sponsor were recorded.

Discussion and conclusions: The findings reveal extensive exposure to gambling advertising during Czech football broadcasts, substantially exceeding the levels documented in prior studies. The predominance of sports betting content and sophisticated promotional techniques, including celebrity endorsements and contextual adaptation to the approaching parliamentary elections, demonstrates comprehensive marketing strategies targeting broader audiences. These results highlight the need for regulatory consideration of gambling advertising exposure in sports broadcasting within the Czech Republic.

Background and aims: Compulsive exercise (CE) has significant theoretical overlap with obsessive-compulsive disorder. No research has examined the relationship between CE and trichotillomania and skin picking disorder, common conditions on the obsessive-compulsive spectrum.

Methods: A total of 382 adults (mean age = 29.2, 78.0% female) with trichotillomania (n = 203) and/or skin picking disorder (n = 276) completed an online survey. Participants who met criteria for CE on the Minnesota Impulse Disorders Interview were compared to those who did not meet these criteria on demographics, a clinical measure of hair pulling/skin picking severity and impairment, and various personality traits.

Results: The prevalence of CE in the sample was 10.2% (n = 39). Subjects who screened positive for CE were more likely to be male (p = .003), were less likely to engage in hair pulling/skin picking daily (p < .001), had more hair pulling/skin picking-related impairment (p < .001), reported more physical/verbal aggression, anger, and hostility (p < .001), and reported being less open to experience than those who screened negative (p < .001). In a binary logistic regression model, hair pulling/skin picking-related impairment was not significantly associated with CE after accounting for personality traits.

Discussion and conclusions: CE appears to be common in adults with trichotillomania and skin picking disorder, and CE is associated with lower openness to experience and higher trait aggression, anger, and hostility. Mental health providers should screen for CE in these patients and consider how these dimensional traits may influence treatment outcomes.

Background and aims: The Spectrum Hypothesis posits that various forms of problematic usage of the internet (PUI) constitute distinct yet related constructs. However, empirical validation of this hypothesis has largely relied on cross-sectional data, leaving gaps in understanding the co-developmental trajectories of these behaviors during adolescence, their microsystem predictors, and how identified trajectories are associated with mental health outcomes. This study thus aimed to: (a) identify the heterogeneous co-developmental trajectories of problematic social media use, short video use, and internet game use; (b) examine the microsystem-level factors that predict membership in these distinct trajectories; and (c) investigate how these trajectory classes are associated with mental health outcomes.

Methods: A total of 1,975 Chinese middle school students (Mage = 13.51, 52.56% girls) completed measures on three occasions across one year.Results: Parallel process latent class growth modeling revealed five distinct trajectory groups: Low-Stable (61.0%), High-Increasing (8.1%), High-Stable Gaming and Moderate-Decreasing Social Media (15.5%), High-Stable Social Media and Short Video (6.9%), and Moderate-Increasing Social Media (8.4%). Harsh parenting, teacher-student conflict, and bullying victimization predicted worsening co-developmental trajectories. In addition, the High-Increasing class had higher risks for adverse mental health outcomes (i.e., depression, anxiety, and suicidality) compared to the Low-Stable class, whereas other high-risk classes also showed poorer outcomes (though less severe).

Conclusions: These findings support the Spectrum Hypothesis from a developmental perspective, highlighting the importance of considering heterogeneity in understanding the co-developmental patterns of PUI forms, their microsystem predictors, and cumulative effects on adolescent mental health.

Background and aims: Problematic usage of the internet (PUI) is a growing global concern, emerging among more than 5.3 billion people who use the internet worldwide. While specific forms such as online gaming and gambling are recognized as disorders or conditions for further study in diagnostic manuals, global data on prevalence, treatment, and health responses to PUI remain limited. This study aimed to obtain perspectives from representatives of addiction medicine/psychiatry societies regarding the scope, treatment, and health responses to PUI and identify gaps.

Methods: A global survey was conducted through the International Society of Addiction Medicine's Global Expert Network (ISAM-GEN), involving addiction societies from 38 countries across Europe, Asia/Oceania, the Americas, and Africa. The survey assessed responses to non-specific PUI and five subtypes: online gaming, gambling, pornography, social media, and online shopping. It included case scenarios and questions on the significance and severity of PUI, and country-level health responses.

Results: Online gambling (94.8%) and gaming (86.9%) were the most frequently reported PUI forms, followed by social media (84.2%), pornography (68.3%), and online shopping (52.6%). Psychotherapeutic approaches, particularly cognitive behavioral therapy, were the most widely available treatments, reported as accessible by over 70% of country respondents. Despite growing awareness-reflected in the formation of PUI interest groups in 44.7% of societies-gaps were reported, including lack of professional certification (78.9%), insufficient practitioner education (68.4%), and inadequate expert training (63.2%). Notably, 65.8% rated the 10-year severity of PUI as extremely or very important.

Discussion & conclusion: Global attention to PUI is increasing, but more robust healthcare responses are needed. Addressing existing gaps requires enhanced training and sustainable international efforts.

Background: Many theories of gambling harm propose that some design features of interactive sports-betting platforms confer a risk of harm by enabling cyclical patterns of repeated gambling engagement. This exploratory study investigated whether such features were used more frequently by people at higher risk of gambling harm relative to a demographically matched lower-risk control group.

Methods: This study used a case-control design to compare 85 people at higher risk of gambling harm (PGSI 5+) with an age- and gender-matched control group at lower risk of harm (n = 84, PGSI 0-4). We compared the frequency with which groups self-reported using in-play betting, cash-out, multi bets, proposition bets, social betting, and viewing live matches within a betting app.

Results: The higher-risk group reported more frequent use of in-play betting and instant cash-out and were more likely to report streaming live sporting events within a betting app. Higher-risk participants were also more likely to make an immediate deposit to qualify for a marketing offer, and both groups reported being more likely to make risky bets when using bonus funds. We observed no group differences in the frequency of use of multi bets, proposition-bets, or social betting.

Conclusions: Our findings were broadly consistent with the theory that design features of betting platforms that facilitate continuous engagement contribute to gambling harm. A notable finding was that in-app streaming of live events was more common among people at higher risk of harm, consistent with a novel prediction made by the motivating theory.

Background and aims: Gambling disorder (GD) patients continue to gamble despite negative consequences, and this behavior can be partly attributed to their insensitivity to failures and losses. GD may worsen over time and may stem from dysfunctions in the reward system and habenula, which encodes negative reward prediction errors. We aimed to elucidate habenular volume alterations that could intensify with illness duration and demonstrate heterogeneity in GD patients.

Methods: Sixty-eight male GD patients and 75 male healthy controls were included. We computed the habenular volume by deep learning-based auto-segmentation from T1-weighted MRI data and examined the between-group differences. We retrospectively calculated illness duration and evaluated the effects of illness duration, personality traits, and symptom severity on habenular volume in GD patients.

Results: GD patients showed comparable habenular volumes to those of healthy participants. After controlling for age, smoking status, IQ, and MRI scanner model, partial correlation analysis revealed a negative correlation between illness duration and habenular volume in GD patients (r = -0.26, p = 0.029). A significant correlation between habenular volume and illness duration appeared only in the severe subgroup (r = -0.42, p = 0.011). In the severe subgroup, higher neuroticism and lower conscientiousness were associated with larger habenular volume.

Discussion and conclusions: Habenular volume was negatively correlated with illness duration in GD patients, particularly in severe cases, and was influenced by symptom severity and personality traits. Habenular structural heterogeneity is based on severity and personality and possibly contributes to persistent gambling despite aversive consequences.

Background and aims: Gambling disorder (GD) poses severe impacts on both individuals and society. Impairment in risky decision-making is a key behavioral characteristic of GD, but the underlying cognitive processes of these deficits remain unclear.

Methods: A total of 100 male participants with GD and 59 healthy controls were recruited to complete psychological assessments and the Balloon Analog Risk Task. Since GD involved abnormal loss evaluation, we developed a novel cognitive model incorporating diminishing loss sensitivity and revealed the processes underlying the risk-taking behaviors with hierarchical Bayesian analysis.

Results: Participants with GD exhibited stronger loss aversion (H1 = 50.00, p < 0.001, η2 = 0.325) but faster-diminishing loss sensitivity (H1 = 24.60, p < 0.001, η2 = 0.152), regardless of severity. The faster-diminishing loss sensitivity can explain the deficits in the overall performance of risky decision-making (H1 = 6.79, p = 0.009, η2 = 0.039; β = 206.81, 95% HDI [135.13, 278.49], t93 = 5.66, p < 0.001, Cohen's d = 0.565). Overconfident prior belief (H1 = 8.58, p = 0.003, η2 = 0.050) and higher updating rate (H1 = 7.91, p = 0.005, η2 = 0.049) were observed among participants with GD. Slower diminishing loss sensitivity was negatively correlated with higher non-planning impulsiveness (R = -0.24, p = 0.015).

Discussion and conclusions: This research provides novel perspectives on cognitive processes underlying the risky decision-making of GD, highlighting the role of diminishing loss sensitivity during loss evaluation and its clinical implications, which inspire future research on assessment and therapy for GD.