Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?

Abstract

This article provides a narrative review of the relationships between several behavioural addictions [pathological gambling, problematic Internet use (PIU), problematic online gaming, compulsive sexual behaviour disorder, compulsive buying, and exercise addiction] and psychiatric disorders. Associations between most behavioural addictions and depressive and anxiety disorders are strong and seem relatively non-specific. Strong links with substance use disorders may support the notion that some people are more prone to addictive behaviours, regardless of whether these involve substances or problematic activities. Other associations seem relatively specific, for example, those between PIU/online gaming and attention-deficit/hyperactivity disorder, between compulsive buying on the one hand and eating disorders and hoarding on the other hand and between exercise addiction and eating disorders. The quality of the research varies, but most studies suffer from methodological limitations, including a cross-sectional or correlational design, non-representative study populations, small sample sizes, reliance on self-report assessment instruments, diverse diagnostic criteria, and conceptual heterogeneity of most behavioural addictions. Due to these limitations, generalisability of the findings is questionable and the direction of causality, if any, is unknown in the relationships between behavioural addictions and psychiatric disorders. Regardless of the aetiological uncertainty, these relationships often call for a modified treatment approach. Prospective studies are needed to clarify the longitudinal relationships between behavioural addictions and psychiatric disorders.

Sexual Desire, Mood, Attachment Style, Impulsivity, and Self-Esteem as Predictive Factors for Addictive Cybersex (Preprint)

“…Such associations suggest that excessive cybersex is at least partly a coping behavior that aims to regulate negative emotions [18,35,36,41,59]. This finding opens the debate, as has occurred for other Internet addictive-like behaviors, about an appropriate diagnostic framework [14] and adequate understanding of such an association [60]. The possible development of psychopathological distress and depression secondary to the negative impact of addictive cybersex (interpersonal isolation, reduction of offline sexual activities) cannot be ruled out [61] and thus, further prospective studies are warranted.…”

Glücksspielsucht über das Internet – eine Übersicht der Situation in der Schweiz

“…Jugendliche Spieler sind durch ihr impulsives Verhalten besonders gefährdet für die Entwicklung einer Spielsucht und gelten als vulnerable Spieler [15,31]. Komorbide psychiatrische Krankheiten, insbesondere solche, die eine Impulskontrollstörung oder eine Emotionsregulationsstörung aufweisen, sind ebenfalls häufig im Zusammenhang mit der Spielstörung beobachtet worden [32][33][34][35].…”

“…Substanzabhängigkeit, affektive Störungen, Angststörungen oder Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung wurden häufig im Zusammenhang mit der Spielstörung beobachtet [32]. In sämtlichen Studien versuchte man Zusammenhänge zwischen den komorbiden psychiatrischen Krankheiten zu finden.…”

Game Addiction Scale Assessment Through a Nationally Representative Sample of Young Adult Men: Item Response Theory Graded�Response Modeling (Preprint)

“…The following 4 criteria, described by some authors of core addiction criteria [20,30], received more consensus than the other criteria did: unsuccessful attempts to reduce or stop [4]; loss of interest in previous hobbies or activities [32,58,59]; continue despite problems [4,30,59]; and jeopardized or lost a relationship, job, or educational or career opportunity [59]. When observing such criteria, careful attention must be paid to possible coping motives (ie, related to a depressive disorder) before attributing any such symptoms to addictive behavior [58,60].…”