Thinking beyond substances: Why behavioral "addiction" research must move past substance use disorder paradigms.

In this viewpoint article, the authors contend that behavioral addiction (BA) research must move past substance use disorder paradigms. Under the most liberal definitions of BA, activities such as eating, exercise, work, smartphone use, and a litany of others could all become addictions. Abundant clinical evidence shows that people may frequently engage in behaviors in ways that become impairing. Yet, frequency of engagement in a behavior is insufficient evidence that addiction is occurring and may be of little evidentiary value at all. There are also severe problems with assuming equivalence between all behavioral processes and substance use. The conceptual problems manifest in methodological problems, meaning that many of the methodological approaches used in substance use research are likely not valid for BA research. Given abundant evidence that the behavior patterns commonly referred to as BAs are associated with distress and impairment, BAs are likely to continue to garner interest in both clinical care and clinical science. To better understand the phenomenology of BAs, research should first start with systematic and multimethod investigations among patients reporting such problems. That is, rather than simply co-opting methods and measures from substance use disorder (SUD) research, BA research should carefully consider the signs and symptoms reported by people experiencing real impairments from excessive and dysregulated behavioral engagements. Additionally, BA researchers should seek to engage with larger theoretical perspectives on psychopathology regarding the core processes that seem to be driving such impairments. For BA research to achieve scientific legitimacy, explain clinical phenomena, and, ultimately, reduce human suffering, the study of such disorders must move beyond SUD paradigms and addiction framing alone and instead strive for riskier tests of validity. (PsycInfo Database Record (c) 2025 APA, all rights reserved).