Journal of Behavioral Addictions

Machine Learning(s) in gaming disorder through the user-avatar bond: A step towards conceptual and methodological clarity
Stavropoulos V, Prokofieva M, Zarate D, Colder Carras M, Ratan R, Kowert R, Schivinski B, Burleigh TL, Poulus D, Karimi L, Gorman-Alesi A, Brown T, Gomez R, Hein K, Arachchilage N and Griffiths MD
In response to our study, the commentary by Infanti et al. (2024) raised critical points regarding (i) the conceptualization and utility of the user-avatar bond in addressing gaming disorder (GD) risk, and (ii) the optimization of supervised machine learning techniques applied to assess GD risk. To advance the scientific dialogue and progress in these areas, the present paper aims to: (i) enhance the clarity and understanding of the concepts of the avatar, the user-avatar bond, and the digital phenotype concerning gaming disorder (GD) within the broader field of behavioral addictions, and (ii) comparatively assess how the user-avatar bond (UAB) may predict GD risk, by both removing data augmentation before the data split and by implementing alternative data imbalance treatment approaches in programming.
Mainland China's 2021 restrictions on under-18s' video game time were imposed when older 2019 restrictions already applied: Omitting the historical regulatory context is misleading
Xiao LY
Investigating the impacts of addiction policymaking following implementation is important. Effective policies should be considered for emulation elsewhere, whilst ineffective policies should be repealed. Zhou et al. (2024) reported how Mainland Chinese under-18s responded to the 2021 restrictions on their online videogame playtime, which were intended to curb online gaming addiction. However, Zhou et al. failed to mention that Mainland China had previously tried to achieve the same regulatory aim by imposing rules in 2019 that were more lenient than the 2021 rules but nonetheless restricted under-18s' gameplay time. These 2019 restrictions were neither acknowledged as crucial background in the introduction section nor accounted for by Zhou et al. when interpreting their results, thus giving readers the incorrect impression that the 2021 rules were the first ones introduced and that under-18s' gameplay time was not restricted at all prior to 2021. Importantly, Zhou et al.'s entire sample of young people therefore consisted not merely of 'heavy gamers' as they euphemistically described them as, but 'counterplayers' who actively contravened the 2019 rules. The misleading omission of this context is a major limitation and misrepresentation. The results should be interpreted accordingly and not overgeneralised.
Long-term changes on behavioral addictions symptoms among adults with attention deficit hyperactivity disorder treated with methylphenidate
Grassi G, Moradei C and Cecchelli C
Attention deficit hyperactivity disorder (ADHD) and behavioral addictions (BAs) are highly comorbid but little is known about the effect of anti-ADHD medications on behavioral addiction symptoms. Thus, the aim of this naturalistic prospective study was to investigate the long-term changes on BAs symptoms among methylphenidate-treated adults with a primary diagnosis of ADHD.
User-avatar bond as diagnostic indicator for gaming disorder: A word on the side of caution
Infanti A, Giardina A, Razum J, King DL, Baggio S, Snodgrass JG, Vowels M, Schimmenti A, Király O, Rumpf HJ, Vögele C and Billieux J
In their study, Stavropoulos et al. (2023) capitalized on supervised machine learning and a longitudinal design and reported that the User-Avatar Bond could be accurately employed to detect Gaming Disorder (GD) risk in a community sample of gamers. The authors suggested that the User-Avatar Bond is a "digital phenotype" that could be used as a diagnostic indicator for GD risk. In this commentary, our objectives are twofold: (1) to underscore the conceptual challenges of employing User-Avatar Bond for conceptualizing and diagnosing GD risk, and (2) to expound upon what we perceive as a misguided application of supervised machine learning techniques by the authors from a methodological standpoint.
Corrigendum to: Deep learning(s) in gaming disorder through the user-avatar bond: A longitudinal study using machine learning
Stavropoulos V, Zarate D, Prokofieva M, Van de Berg N, Karimi L, Gorman Alesi A, Richards M, Bennet S and Griffiths MD
Unemployment as a risk factor for gambling disorder: A longitudinal study based on national registry data
Syvertsen A, Leino T, Smith ORF, Mentzoni RA, Sivertsen B, Griffiths MD and Pallesen S
Unemployment rates are elevated among individuals with disordered gambling, yet the directionality of the relationship remains unclear. The present study investigated paid and unpaid unemployment as risk factors for future gambling disorder (GD).
Evaluation of a multicomponent positive psychology program to prevent gaming disorder and enhance mental wellness in primary pupils: A randomized controlled trial
Cheng C, Li S and Chen S
Gaming disorder (GD) is a prevalent and complex issue that has recently been recognized as a condition that impairs mental health, underscoring the urgent need for early prevention measures. This evaluation study examined the effectiveness of the Digital Netizen Alliance (D.N.A.) program, a new multicomponent positive psychology program for preventing GD and bolstering mental wellness among Chinese children.
Prediction of craving across studies: A commentary on conceptual and methodological considerations when using data-driven methods
Antons S, Yip SW, Lacadie CM, Dadashkarimi J, Scheinost D, Brand M and Potenza MN
Craving is a central feature of substance use disorders and disorders due to addictive behaviors. Considerable research has investigated neural mechanisms involved in the development and processing of craving. Recently, connectome-based predictive modeling, a data-driven method, has been used in four studies aiming to predict craving related to substance use, addictive behaviors, and food. Studies differed in methods, samples, and conceptualizations of craving. Within the commentary we aim to compare, contrast and consolidate findings across studies by considering conceptual and methodological features of the studies. We derive a theoretical model on the functional connectivity-craving relationships across studies.
Rethinking cutoff values for the South Oaks Gambling Screen: Sex-specific insights and DSM-5 severity adjustments in Gambling Disorder assessment
Lucas I, Granero R, Mora-Maltas B, Fernández-Aranda F and Jiménez-Murcia S
The South Oaks Gambling Screen (SOGS) is a commonly used tool for screening potential gambling problems. The SOGS score has been found to be correlated with the DSM-5 criteria for Gambling Disorder (GD). However, one of its main limitations is the high rate of false positives. The objective of this study was to establish more accurate cutoff points for the SOGS based on the DSM-5 criteria and severity levels, taking into account sex-specific samples. Additionally, we aimed to validate these cutoff points using external measures.
Emotional difficulties mediate the impact of adverse childhood experiences on compulsive buying-shopping problems
David J, Kim HS, Hodgins DC, Dawson SJ, Tabri N, Shead NW and Keough MT
Compulsive buying-shopping is recognised as a significant mental health concern, yet its aetiology is largely understudied. A known risk factor for compulsive buying-shopping is adverse childhood experiences (ACEs). ACEs are also associated with greater problems regulating emotions, as well as depression and anxiety. These factors are also known to be associated with compulsive buying-shopping problems. In this study, we aimed to test a serial mediation model in which ACEs were associated with compulsive buying-shopping problems via emotion dysregulation, and then emotional psychopathology (depression, anxiety).
Illusions of control: A quasi-experiment comparing skill-based and traditional slot machines
Rockloff M, Russell AMT, Hing N, Browne M, Thorne H, Newall P and Visintin T
Electronic gaming machines (EGMs) are a significant source of gambling spend due to their widespread use. Skill-based gambling machines (SGMs) represent an innovative adaptation, merging EGMs' chance-based rewards with video game-like skills. This study aimed to explore the appeal and behavioural consequences of playing SGMs in comparison to traditional reel-based EGMs, particularly focusing on illusions of control, betting behaviour, and the subjective experience of gamblers.
"Phones off while school's on": Evaluating problematic phone use and the social, wellbeing, and academic effects of banning phones in schools
King DL, Radunz M, Galanis CR, Quinney B and Wade T
Mobile phone bans in secondary schools are claimed to reduce student distraction and promote learning and face-to-face socializing. Currently, the evidence on phone bans is limited. The aim of this preregistered study was to evaluate the South Australian mobile phone ban's effects on students' problematic phone use, academic engagement, school belonging, and bullying. The study also sought to identify student variables that predict phone ban compliance.
Longitudinal trait and state-like differences in the components model of addiction: An illustration through social media addiction and work addiction
Horváth Z, Kun B, Király O, Paksi B, Griffiths MD and Demetrovics Z
Conflicting findings have been reported for the longitudinal course of behavioral addictions, especially for social media addiction (SMA) and work addiction (WA). Therefore, evaluating whether these constructs are more trait-like or state-like might be informative. The aim of the present study was to examine the proportion of variance of SMA and WA symptoms (as defined by the components model of addiction) explained by trait and occasion-specific factors in addition to exploring cross-lagged relationships between SMA and WA.
The influence of age on gambling problems worldwide: A systematic review and meta-analysis of risk among younger, middle-aged, and older adults
Dellosa G and Browne M
Problem gambling (PG) represents a significant public health concern with widespread effects in various cultures and regions globally, with younger individuals and males at a particularly higher risk. This disparity is attributed to a mix of cultural, developmental, and biological influences. To date, there has not been a comprehensive examination to determine whether this risk pattern holds consistently across different jurisdictions.
Internet gaming disorder and risky behaviours among Czech adolescents: A nationally representative study
Suchá J, Dolejš M, Dostál D, Pipová H and Pontes HM
The aim of the present study was to estimate the complex association between Internet Gaming Disorder (IGD), substance use, and other risky behaviours in Czech adolescents whilst providing prevalence estimates of IGD and psychometric information regarding the Czech Internet Gaming Disorder Scale-Short-Form (IGDS9-SF).
How much gaming is too much? An analysis based on psychological distress
Katz D, Horváth Z, Pontes HM, Koncz P, Demetrovics Z and Király O
While there are calls to restrict the time spent on gaming because it is seen as problematic and potentially leading to gaming disorder (GD), there is conflicting evidence about this issue. We explored the association between the average weekly time spent gaming and reported GD symptoms. Additionally, Latent Profile Analysis was employed to investigate how time spent gaming relates to variables representing psychological distress (PD), such as satisfaction with life, symptoms of depression, and perceived stress.
Emotional interference and attentional bias in compulsive sexual behaviors disorder - An fMRI study on heterosexual males
Draps M, Kulesza M, Glica A, Szymanowska J, Lewińska K, Żukrowska W and Gola M
Despite the inclusion of the Compulsive Sexual Behavior Disorder (CSBD) in the 11th edition of the International Classification of Diseases, emotional and cognitive impairments related to CSBD remains unclear. This study aimed to investigate the behavioral and neuronal effects of emotional interference on cognition among CSBD patients.
The Gaming Disorder Identification Test (GADIT) - A screening tool for Gaming Disorder based on ICD-11
Chan GCK, Saunders JB, Stjepanović D, McClure-Thomas C, Connor J, Hides L, Wood A, King D, Siste K, Long J and Leung JK
Gaming Disorder was included as an addictive disorder in the latest version of the International Classification of Diseases (ICD-11), published in 2022. The present study aimed to develop a screening tool for Gaming Disorder, the Gaming Disorder Identification Test (GADIT), based on the four ICD-11 diagnostic criteria: impaired control, increasing priority, continued gaming despite harm, and functional impairment.
Attentional bias to social media stimuli is moderated by fear of missing out among problematic social media users
Wang Y, Elhai JD, Montag C, Zhang L and Yang H
Previous evidence has indicated that problematic social media use (PSMU) is characterized by an attentional bias to social media icons (such as Facebook icons), but not to social webpages (such as Facebook webpages). They suggest that there may be other factors influencing attentional bias like fear of missing out (FoMO). But it remains unclear how FoMO moderates attentional bias in PSMU. This study aims to investigate whether PSMU show attentional bias for stimuli associated with social media, and how FoMO moderates on attentional bias among PSMU through experimental methods.
A comprehensive evaluation of the neurocognitive predictors of problematic alcohol use, eating, pornography, and internet use: A 6-month longitudinal study
Christensen E, Albertella L, Chamberlain SR, Suo C, Brydevall M, Grant JE, Yücel M and Lee RSC
Cognitive control and reward-related abnormalities are centrally implicated in addiction. However, findings from longitudinal studies addressing neurocognitive predictors of addictive behaviors are mixed. Further, little work has been conducted predicting non-substance-related addictive behaviors. Our study aimed to assess predictors of substance and non-substance addictive behaviors in a community sample, systematically evaluating each neurocognitive function's independent influence on addictive behavior.
Blunted sensitivity to expected value during risky decision making in individuals with problematic pornography use
Wang J, Qu S, Li R, Tang S and Li H
Neurobiological models of addiction posit that addiction manifests through an amplified salience towards addiction-associated stimuli and a diminished responsiveness to non-addiction-related incentives. However, existing research on reward processing in individuals with problematic pornography use (PPU) has primarily been limited to sexual cue reactivity.
A familial subtype of gambling disorder
Grant JE, Aslan I and Chamberlain SR
Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive gambling family history means for people with gambling disorder. We sought to understand the clinical impact of having a first-degree relative with gambling disorder in a sample of adults with gambling disorder.
The PornLoS Treatment Program: Study protocol of a new psychotherapeutic approach for treating pornography use disorder
Stark R, Markert C, Golder S, Psarros R, Discher JP, Khatib S, Metzger J, Palmer S, Rechmann J, Storz F, Walter B, Allard S, Antons S, Bledzka M, Brand M, Dörrenbächer S, Englisch J, Friehs T, Da Cunha Gonçalves K, Haberkamp A, Hall M, Kananian S, Kemmerer P, Klingelhöfer D, Lutz W, Melzig CA, Michael T, Neumann A, Neusser S, Niemann A, Odenthal M, Rubel J, Schlierenkamp S, Speckemeier C, Ünlü L, Vogt R, Wölfling K, Zachariassen W, Zur Hausen G and Heinz C
The introduction of Compulsive Sexual Behavior Disorder (CSBD) into the 11th International Classification of Diseases has raised expectations for better treatment options for CSBD. Furthermore, the treatment demand has increased, particularly for pornography use disorder (PUD), a subtype of CSBD. Presumably due to the easy access to Internet pornography an increasing prevalence of PUD is observed. Consequently, providing tailored and effective treatment is essential.
Spatio-temporal EEG dynamics during decision-making in online poker players with problem gambling
Giustiniani J, Nicolier M, Maylié F, Pazart L, Haffen E and Gabriel D
Gambling activity evolves along a continuum from recreational to Gambling Disorder (GD) and a particular challenge is to identify whether there are some neurophysiological particularities already present in gamblers at an early stage. Our main goal was to determine whether, in the gamblers' population, neural responses generated during uncertain decisions were different depending on problematic gambling risk defined by the Canadian Problem Gambling Index (CPGI). We tested the following hypothesis, that the Problem Gambling group would show a different brain activity related to outcomes processing than people with low risk.
Comparative analysis of cortical anatomy in male participants with internet gaming disorder or tobacco use disorder: Insights from normative modeling
Ma X, Jiang A, Dai J, Li S, Chen H, Xie Y, Wang S, Yang B, Wang L and Dong GH
Research on individual differences in brain structural features of internet gaming disorder (IGD) and established addictions such as tobacco use disorder (TUD) is currently limited. This study utilized normative modeling to analyze the cortical thickness (CT) development patterns of male patients with IGD and TUD, aiming to provide further insights into whether IGD qualifies as an addiction.
Clinical characteristics associated with problematic pornography use among individuals seeking treatment for opioid use disorder
Stefanovics EA, Kraus SW, Madden LM, Farnum S, Cannata E, Potenza MN and Barry D
Many jurisdictions are experiencing opioid epidemics. Opioid use disorder (OUD) often co-occurs with other psychiatric disorders including behavioral addictions like gambling disorder. However, little is known regarding the frequency and correlates of problematic pornography use (PPU) among people seeking treatment for OUD. Here we aimed to investigate PPU and its correlates in people seeking OUD treatment.
Gene-environment interaction between gaming addiction and perceived stress in late adolescents and young adults: A twin study
Hur YM
The association between perceived stress (PS) and gaming addiction (GA) is well documented. However, the mechanism for explaining this association remains unclear. Using a genetically informative design, this study aims to distinguish between the diathesis-stress and bio-ecological models of gene by environment interaction (G x E) to explain the underlying mechanism of the relationship.
Co-occurring compulsive sexual behaviour in an inpatient substance use population: Clinical correlates and influence on treatment outcomes
Snaychuk LA, Dermody SS, Tabri N, Basedow CA and Kim HS
Many individuals with substance use disorders (SUDs) present with co-occurring mental health disorders and other addictions, including behavioral addictions (BAs). Though several studies have investigated the relationship between SUDs and BAs, less research has focused specifically on compulsive sexual behaviour (CSB). Given that poly-addiction can hinder treatment outcomes, it is necessary to better understand the impact of co-occurring CSB and SUD. Therefore, the current study aimed to 1) determine the rate of CSB in a sample seeking treatment for SUDs, 2) identify demographic and clinical correlates of co-occurring CSB, and 3) to determine if co-occurring CSB impacts treatment outcomes for SUD.
Is decreasing problematic mobile phone use a pathway for alleviating adolescent depression and sleep disorders? A randomized controlled trial testing the effectiveness of an eight-session mindfulness-based intervention
Liu Q, Yang X, Zhang C and Xiong J
The present study aimed to evaluate the efficacy of a mindfulness-based cognitive therapy (MBCT) intervention in reducing problematic mobile phone use, depression, and sleep disorders among adolescents. Additionally, it sought to investigate whether the decrease in problematic mobile phone use acted as a mediator in the relationship between the MBCT intervention and adolescent depression and sleep disorders.
Frontal white and gray matter abnormality in gambling disorder: A multimodal MRI study
Bellmunt-Gil A, Vorobyev V, Parkkola R, Lötjönen J, Joutsa J and Kaasinen V
Changes in brain structural connections appear to be important in the pathophysiology of substance use disorders, but their role in behavioral addictions, such as gambling disorder (GD), is unclear. GD also offers a model to study addiction mechanisms without pharmacological confounding factors. Here, we used multimodal MRI data to examine the integrity of white matter connections in individuals with GD. We hypothesized that the affected areas would be in the fronto-striatal-thalamic circuit.