Criteria for the establishment of a new behavioural addiction •

Abstract

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.

Eating addiction

“…Thus, unlike the food addiction approach, it is hardly feasible to just take the diagnostic criteria of gambling disorder and translate them to refer to food and eating (Meule & Gearhardt, 2014b). While there have been several suggestions for a set of symptoms that are applicable across different behaviors, there has not been a consensus on diagnostic criteria across or overarching criteria for establishing new behavioral addictions (Goodman, 1990;Gullo et al, 2022). Interestingly, it appears that experts in the field of behavioral addictions do actually not really consider eating addiction as part of the behavioral addictions spectrum.…”

Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples

“…The Diagnostic and Statistical Manual fifth Edition (DSM-5-TR) ( American Psychiatric Association, 2022 ) lists a series of potential “official”, yet very broad diagnostic labels that could, theoretically, be applied for some people with PPU, such as ‘unspecified sexual dysfunction’ (302.70/F52.8; Krueger, 2016 ), ‘unspecified obsessive-compulsive and related disorder’ (300.3), or ‘unspecified disruptive, impulse-control, and conduct disorder’ (312.9; Stark & Klucken, 2017 ). Following much debate ( Gullo et al, 2022 ; Sassover & Weinstein, 2022 ), PPU can now be clinically recognised as an impulse control disorder in the International Classification of Diseases, eleventh edition (ICD-11) under the more specific entity compulsive sexual behaviour disorder (CSBD; Kraus et al, 2018 ). Some experts also argue that PPU aligns with a behavioural addiction model and could therefore be formally recognised in the ICD-11 as an ‘other specified disorders due to addictive behaviours’ ( Brand et al, 2020 ), although data specific to this classification are currently limited.…”

Behavioral addictions in the ICD-11: An important debate that is anticipated to continue for some time

“…The third debate paper also concentrates on CSBD and concluded that there is currently not enough empirical support for considering CSBD a behavioral addiction ( Sassover & Weinstein, 2022 ). Of the eleven commentaries, seven relate to CSBD ( Borgogna & Aita, 2022 ; Briken & Turner, 2022 ; Bőthe, Koós, & Demetrovics, 2022 ; Castro-Calvo et al., 2022 ; Jennings, Gleason, & Kraus, 2022 ; Lew-Starowicz & Coleman, 2022 ; Rumpf & Montag, 2022 ) and four to the meta-level criteria ( Griffiths, 2022 ; Gullo, Wood, & Saunders, 2022 ; Kuss & Lopez-Fernandez, 2022 ; Stein & Lochner, 2022 ), although there are also commentaries which included both a discussion of the meta-criteria and related topics and a discussion of specific criteria for CSBD (e.g., Borgogna & Aita, 2022 ; Griffiths, 2022 ; Jennings et al., 2022 ; Rumpf & Montag, 2022 ). This overlap is not surprising given that CSBD (or problematic pornography use or “pornography-use disorder” more specifically) is one example of a potential disorder to be considered as “other specified disorders due to addictive behaviors” in the debate paper on meta-criteria ( Brand et al., 2022 ).…”