Criteria for conceptualizing behavioural addiction should be informed by the underlying behavioural mechanism

Criteria for the establishment of a new behavioural addiction •

When does repeated behaviour constitute behavioural addiction? There has been considerable debate about non-substance-related addictions and how to determine when impaired control over a behaviour is addiction. There are public health benefits to identifying new behavioural addictions if intervention can improve outcomes. However, criteria for establishing new behavioural addictions must guard against diagnostic inflation and the pathologizing of normal problems of living. Criteria should include clinical relevance (Criterion 1), alignment with addiction phenomenology (Criterion 2) and theory (Criterion 3), and taxonomic plausibility (Criterion 4). Against such criteria, evidence does not yet support classification of pornography-use and buying-shopping disorders as addictions.

Measurement of shopping addiction and its relationship with personality traits and well-being among Polish undergraduate students

There is still a scarcity of studies showing the relative contribution of different personality characteristics differentiating various behavioral addictions within an integrated model. In comparison to other addictions, fairly little is known about the role of specific personality traits in compulsive shopping. In addition, few studies have investigated the unique contribution of shopping addiction in terms of explaining different facets of well-being above and beyond personality characteristics previously shown to be related to psychosocial functioning. The present study shows validation of the Bergen Shopping Addiction Scale (BSAS) and a tentative integrated model of potential shopping addiction personality risk factors. BSAS was administered to 1156 Polish students. In addition, demographic variables, and personality traits (Big Five), self-esteem, self-efficacy, perceived narcissism, loneliness, social anxiety, and well-being indicators were measured. BSAS had acceptable fit with the data and demonstrated good reliability. The investigated model showed that shopping addiction was related to higher extraversion, perceived narcissism, and social anxiety, and lower agreeableness and general self-efficacy. Woman and older participants scored higher on BSAS. Shopping addiction was further related to all facets of impaired well-being and explained worse general health, and decreased sleep quality above and beyond other variables in the model. The results support the notion that shopping addiction may have specific personality risk factors with low agreeableness as an outstanding characteristic. This has implications for the development of early prevention and intervention programs.

Physical Sports Activities and Exercise Addiction during Lockdown in the Spanish Population

The coronavirus disease 2019 (COVID-19) pandemic has led to the paralysis of the worldwide economy caused by the population's lockdown to stop the virus spreading, making it difficult to do exercise. The aim of this study is to analyse the commitment to and feeling of insecurity related to practising sport, sports habits and the profile of the Spanish population during lockdown according to the level of addiction to exercise. The sample consisted of 1019 subjects with a mean age of 35 years old. The variables analysed were exercise addiction, commitment to and feeling of insecurity related to sport, and sport habits. Three groups were identified according to their addiction level to exercise: asymptomatic (n = 202), symptomatic (n = 756), and at risk of addiction (n = 61). The main results indicated that a higher addiction level was associated with a higher number of days and time spent on exercise per week. Six percent of the subjects were at addiction risk, and they had a lower feeling of insecurity towards sport. These findings provide information to governments on the need to promote physical activity programmes at home to promote adequate fitness and mental wellbeing in the population.

Predictive utility of the brief Screener for Substance and Behavioral Addictions for identifying self-attributed problems

BACKGROUND AND AIMS

The Brief Screener for Substance and Behavioral Addictions (SSBAs) was developed to assess a common addiction construct across four substances (alcohol, tobacco, cannabis, and cocaine), and six behaviors (gambling, shopping, videogaming, eating, sexual activity, and working) using a lay epidemiology perspective. This paper extends our previous work by examining the predictive utility of the SSBA to identify self-attributed addiction problems.

METHOD

Participants (N = 6,000) were recruited in Canada using quota sampling methods. Receiver Operating Characteristics (ROCs) analyses were conducted, and thresholds established for each target behavior's subscale to predict self-attributed problems with these substances and behaviors. For each substance and behavior, regression models compared overall classification accuracy and model fit when lay epidemiologic indicators assessed using the SSBA were compared with validated screening measures to predict selfattributed problems.

RESULTS

ROC analyses indicted moderate to high diagnostic accuracy (Area under the curves (AUCs) 0.73-0.94) across SSBA subscales. Thresholds for identifying self-attributed problems were 3 for six of the subscales (alcohol, tobacco, cannabis, cocaine, shopping, and gaming), and 2 for the remaining four behaviors (gambling, eating, sexual activity, and working). Compared to other instruments assessing addiction problems, models using the SSBA provided equivalent or better model fit, and overall had higher classification accuracy in the prediction of self-attributed problems.

DISCUSSION AND CONCLUSIONS

The SSBA is a viable screening tool for problematic engagement across ten potentially addictive behaviors. Where longer screening tools are not appropriate, the SSBA may be used to identify individuals who would benefit from further assessment.

Maladaptive Personality Functioning and Psychopathological Symptoms in Problematic Video Game Players: A Person-Centered Approach

BACKGROUND

A need exists to increase our understanding of the association between maladaptive personality traits, psychopathological symptoms, game preference, and different types of video game use. In the present study, we used a person-centered approach to identify different subtypes of video game players and we explored how they differ in personality profiles, clinical symptoms, and video game usage.

METHODS

We assessed problematic gaming via the nine-item Internet Gaming Disorder Scale and self-reported screen time playing video games in a sample of 366 adolescents and young adult gamers. Participants also completed measures on maladaptive personality domains (Personality Inventory for DSM-5 Brief Form), alexithymia (Toronto Alexithymia Scale-20 items), and psychopathological symptoms (DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure) and reported which genre of video games they preferred.

RESULTS

Using a person-centered, cluster-analytic approach, we identified four clusters of video game players (Occasional, Passionate, Preoccupied, and Disordered) presenting peculiar combinations of problematic gaming scores and time spent online playing video games. Non-problematic gamers (Occasional and Passionate) represented the majority of the sample (62.3% of the participants). Highly involved gamers who exhibited excessive screen time playing video games (Disordered gamers) presented the highest level of maladaptive personality traits and psychopathological symptoms, and were characterized by the greatest use of Multiplayer Online Battle Arena (MOBA) games.

CONCLUSION

These results have clinical implications on suggesting the importance to determining whether or not problematic gaming activities reflect a dysfunctional emotion-focused coping strategy to avoid inner unpleasant emotional or a more generally compromised emotional and social functioning.

A cluster analysis of text message users based on their demand for text messaging: A behavioral economic approach

The goal of this study was to determine whether cluster analysis could be used to identify distinct subgroups of text message users based on behavioral economic indices of demand for text messaging. Cluster analysis is an analytic technique that attempts to categorize cases based on similarities across selected variables. Participants completed a questionnaire about mobile phone usage and a hypothetical texting demand task in which they indicated their likelihood of paying an extra charge to continue to send text messages. A hierarchical cluster analysis was conducted on behavioral economic indices, such as demand intensity, demand elasticity, breakpoint, and the maximum expenditure. With the cluster analysis, we identified 3 subgroups of text message users. The groups were characterized by (a) high intensity and low elasticity, (b) high intensity and medium elasticity, and (c) low intensity and high elasticity. In a demonstration of convergent validity, there were statistically significant and conceptually meaningful differences across the subgroups in various measures of mobile phone use and text messaging. Cluster analysis is a useful tool for identifying and profiling distinct, practically meaningful groups based on behavioral indices and could provide a framework for targeting interventions more efficiently.

Why and how to include parents in the treatment of adolescents presenting Internet gaming disorder?

BACKGROUND AND AIMS

Clinicians and researchers are increasingly interested in investigating excessive use of video gaming recently named Internet gaming disorder (IGD). As is the case with extensively researched adolescent problem behaviors such as substance use disorder, several studies associate IGD with the young person's family environment and the parent-adolescent relationship in particular. Evidence-based treatments for a range of adolescent clinical problems including behavioral addictions demonstrate efficacy, the capacity for transdiagnostic adaptation, and lasting impact. However, less attention has been paid to developing and testing science-based interventions for IGD, and at present most tested interventions for IGD have been individual treatments (cognitive behavioral therapy).

METHODS

This article presents the rationale for a systemic conceptualization of IGD and a therapeutic approach that targets multiple units or subsystems. The IGD treatment program is based on the science-supported multidimensional family therapy approach (MDFT). Following treatment development work, the MDFT approach has been adapted for IGD.

RESULTS

The article discusses recurring individual and family-based clinical themes and therapeutic responses in the MDFT-IGD clinical model, which tailors interventions for individuals and subsystems within the young person's family.

DISCUSSION AND CONCLUSIONS

Basic science developmental research can inform conceptualization of IGD and a systemic logic model of intervention and change. This paper aims to expand treatment theorizing and intervention approaches for practitioners working with frequently life-altering behaviors of excessive Internet gaming. We operationalize this aim by addressing the question of why and how parents should be involved in youth IGD treatment.

Beyond the myths about work addiction: Toward a consensus on definition and trajectories for future studies on problematic overworking

In an unprecedented collaborative effort to integrate the existing knowledge on work addiction and delineate trajectories for future studies, several papers from work addiction researchers (including some of the most prolific experts in the field) have contributed to the debate on the misconceptions/myths about this problematic behavior. On the basis of the overview of the presented arguments, the most commonly proposed recommendations were that there should be: (a) a general definition of work addiction, (b) the need for more transdisciplinary and integrative approach to research, and (c) propositions regarding more high-quality research. These three aspects are summarized in the present paper. There is a general agreement among work addiction researchers that work addiction is a problematic behavior that merits more systematic studies, which require input and expertise from a wide range of fields due to its complex nature.

Internet gaming disorder in male and female young adults: The role of alexithymia, depression, anxiety and gaming type

The aim of this study is to investigate the relationship between alexithymia and Internet Gaming Disorder (IGD) (while controlling for depression and anxiety), explore the presence of gender differences, and the potential differences between MOBA and MMORPG gamers. A total of 429 young adults (mean age 20.7 years) recruited from different forums dedicated to video games took part in the study and filled a questionnaire including type of video game use, the Game Addiction Scale, the TAS-20 (evaluating alexithymia) and the HADS (evaluation anxiety and depression). In the whole sample, being alexithymic, depression scores, and anxiety scores were associated with IGD. Nevertheless, results differed depending on gender and type of games played. In male gamers, being alexithymic, being young, and having high anxiety and depression scores was associated with IGD. In female gamers, having less than a high school education and a high depression score was associated with IGD. In MOBA gamers, only the difficulty describing feelings factor was associated with IGD while in MMORPGs gamers, graduation from high school and anxiety scores were associated with IGD. Playing MOBA games could be a strategy to regulate emotions while playing MMORPG appears to be a maladaptive coping strategy to deal with negative affective disturbances. Gender and gaming type are important factors in the relationship between alexithymia, depression, anxiety and IGD. These results have some interesting clinical implications, which are discussed.

Can one simple questionnaire assess substance-related and behavioural addiction problems? Results of a proposed new screener for community epidemiology

BACKGROUND AND AIMS

There is currently no well-validated measure that assesses a broad spectrum of substance-related and behavioural addictions in general populations. This study aimed to develop a brief self-attribution Screener for Substance and Behavioural Addictions (SSBA) to screen for four substances and six behaviours, and to compare its performance with established individual-behaviour screening instruments.

DESIGN

A small, psychometrically optimal set of items to assess self-attributed indicators of addiction across alcohol, tobacco, cannabis, cocaine, gambling, shopping, videogaming, overeating, sexual activity and overworking were identified from a broader pool that was developed using a lay epidemiology qualitative approach. The suitability of the four-item single-factor solution was tested for each behaviour and scores were compared with those obtained from the sample using individual-behaviour screening instruments.

SETTING AND PARTICIPANTS

Participants (n = 6000), broadly representative of the Canadian English-speaking adult population, were recruited through the Ipsos Reid Canadian Online Panel.

MEASUREMENTS

Participants completed an item pool of 15 indicators of addiction for each target behaviour and a validation instrument for one randomly assigned behaviour.

FINDINGS

A set of four items identified using principal component and confirmatory factor analyses demonstrated good fit and excellent internal consistency (α = 0.87-0.95) across behaviours, and good convergent validity (rs = 0.44-0.8) with extant instruments measuring similar constructs, with only one exception (r = 0.26).

CONCLUSIONS

The proposed Screener for Substance and Behavioural Addiction is a reliable and valid measure assessing the lay public's self-attributed indicators of addiction across 10 substances and behaviours.

Internet Gaming Disorder in Adolescents: Personality, Psychopathology and Evaluation of a Psychological Intervention Combined With Parent Psychoeducation

Internet Gaming Disorder is an increasingly prevalent disorder, which can have severe consequences in affected young people and in their families. There is an urgent need to improve existing treatment programs; these are currently hampered by the lack of research in this area. It is necessary to more carefully define the symptomatic, psychosocial and personality characterization of these patients and the interaction between treatment and relevant variables. The objectives of this study were three: (1) to analyze the symptomatic and personality profiles of young patients with Internet Gaming Disorder in comparison with healthy controls; (2) to analyze the effectiveness of a cognitive behavioral treatment on reducing symptomatology; and (3) to compare the results of that treatment with or without the addition of a psychoeducational group offered to the parents. The final sample consisted of 30 patients consecutively admitted to a specialized mental health unit in Spain, and 30 healthy controls. The experimental group received individual cognitive-behavioral therapy. The experimental group was divided into two subgroups (N = 15), depending on the addition or not of a psychoeducational group for their parents (consecutively admitted). Scores on the Millon Adolescent Personality Inventory (MACI), the Symptom Checklist-Revised (SCL-90-R), the State-Trait Anxiety Index (STAI), and other clinical and psychopathological measures were recorded. The patients were re-assessed post treatment (except for the MACI questionnaire). Compared with healthy controls, patients did not differ in symptomatology at baseline, but scored significantly higher in the personality scales: Introversive and Inhibited, and in the expressed concerns scales: Identity Confusion, Self-Devaluation, and Peer Insecurity and scored significantly lower in the Histrionic and Egotistic scale. In the experimental group, pre-post changes differed statistically on SCL-90-R scales Hostility, Psychoticism, and Global Severity Index and on the diagnostic criteria for Internet Gaming Disorder, regardless of the addition of a psychoeducational group for parents. Pre-post changes did not differ between experimental subgroups. However, the subgroup without psychoeducation for parents presented statistically higher drop-out rates during treatment. The results of this study are based on a sample of patients seeking treatment related to problems with online gaming, therefore, they may be of value for similar patients.