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Gambling disorder is the only behavioral addiction recognized as a clinical disorder in DSM-5, and Internet gaming disorder is included as a condition requiring further research. ICD-11 categorizes gambling and gaming disorders as disorders due to addictive behaviors. Additional behavioral addictions may include compulsive sexual behavior disorder, compulsive buying-shopping disorder, and problematic use of social media. This narrative review summarizes the current state of knowledge regarding these five (potential) disorders due to addictive behaviors. All five (potential) disorders are clinically relevant and prevalent. Behavioral addictions frequently co-occur with other mental and behavioral problems, such as depression, anxiety, and attention deficit hyperactivity disorder. Validated diagnostic instruments exist, with empirical support varying across conditions. No medications have approved indications from regulatory bodies for behavioral addictions, and cognitive-behavioral therapy has the most empirical support for efficacious treatment. Given that behavioral addictions are prevalent, frequently co-occur with psychiatric disorders, may often go undiagnosed and untreated, and have been linked to poorer treatment outcomes, active screening and treatment are indicated. Public health considerations should be expanded, and impacts of modern technologies should be investigated more intensively. Treatment optimization involving pharmacotherapy, psychotherapy, neuromodulation, and their combination warrants additional investigation., Competing Interests: Drs. Brand, Demetrovics, King, Müller, and Potenza are board members of the International Society for the Study of Behavioral Addictions. Dr. Demetrovics’s university (ELTE Eötvös Loránd University) receives funding from Szerencsejáték Ltd. (the gambling operator of the Hungarian government) to maintain a telephone helpline service for problematic gambling, and his other university (University of Gibraltar) receives funding from the Gibraltar Gambling Care Foundation and donations from gambling operators through the LCCP RET process supervised by the UK Gambling Commission. Dr. Fineberg has held research or networking grants from the National Institute for Health and Care Research, COST Action, the EU, UK Research and Innovation, and Orchard; she has received travel and/or hospitality expense coverage from the British Association for Psychopharmacology, the European College of Neuropsychopharmacology, the Royal College of Psychiatrists, the International College of Neuropsychopharmacology, the International Forum of Mood and Anxiety Disorders, and the World Psychiatric Association; she has received payment from Elsevier for editorial duties and the Mental Health Academy and Children and Screens for lecturing; she leads an NHS treatment service for OCD; she is a board member for various registered charities linked to OCD; she provides expert advice on psychopharmacology to the Medicines and Healthcare Products Regulatory Agency; and she has participated in a WHO working group focusing on diagnosis and classification of obsessive-compulsive or related disorders for ICD-11. Dr. Potenza has served as a consultant for the Addiction Policy Forum, AXA, BariaTek, Game Day Data, Idorsia Pharmaceuticals, and Opiant Therapeutics and has served as a consultant and/or adviser for gambling, health care, nonprofit, and legal entities on issues related to impulse control, Internet use, and/or addictive disorders; he has been involved in a patent application with Yale University and Novartis; he has received research support from Children and Screens, the Connecticut Council on Problem Gambling, and Mohegan Sun Casino; and he has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse control disorders, and other health topics. All of the authors have performed grant reviews for research funding agencies, and/or edited journals or journal sections, and/or given academic lectures in clinical or scientific venues, and/or produced book chapters for publishers of mental health texts.

Background and Aims: There is a lack of research on the impact of acute stress on the interaction of affective and cognitive processes in online compulsive buying-shopping disorder (CBSD). Therefore, this project addressed stress response, cue reactivity, attentional bias, and implicit associations in individuals with online CBSD., Methods: Women with CBSD (n = 63) and women with non-problematic online buying-shopping (n = 64) were randomly assigned to the Trier Social Stress Test or a non-stress condition. After the stress/non-stress induction, participants performed a cue-reactivity paradigm, a dot-probe paradigm, and an implicit association task, each with addiction-related (online buying-shopping) and control (social networks) cues., Results: Individuals with CBSD showed stronger affective responses towards the addiction-related and control cues than the control group and rated the addiction-related pictures with higher 'arousal' and 'urge' than the control images. No group differences emerged in the dot-probe paradigm and implicit association task. Acute stress showed no effect on performance in the behavioural tasks. Regression models investigating the impact of craving on the relationship between stress response and implicit cognitions within the group with CBSD were not significant., Discussion: The findings demonstrate the involvement and generalization of cue reactivity in online CBSD, but do not provide support for effects of acute stress on cue reactivity, attentional bias and implicit associations., Conclusions: Future studies should not be restricted to women and combine laboratory and naturalistic study designs to investigate the complex psychological mechanisms in online CBSD.

Objective: In the present work we investigate how individual differences in at least occasionally using distinct social media platforms is linked to social networks use disorder (SNUD) tendencies. A final sample of n = 2200 participants filled in the AICA-C-9 measure to get insights into individual differences in overuse of social media and participants also indicated which platforms they used at least once a month., Results: The analysis revealed a robust positive association between number of at least occasionally used social media apps and SNUD tendencies (r = .44, p < .001). Further, platforms differed in terms of their "addictive potential", if one takes associations between frequency of distinct platforms use and SNUD tendencies as a proxy for this (and of course the actual descriptive statistics of the SNUD scale for the (non-)frequent user groups of the different platforms). In this regard, at least occasionally using some platforms (here Tumblr, Twitter and TikTok) was associated with highest SNUD tendencies. Moreover, largest differences in terms of effect sizes between the occasional and non-occasional user groups regarding SNUD scores could be observed for Instagram, WhatsApp, and TikTok. The present work bases on data from a larger project investigating associations between SNUD and tobacco use disorder., (© 2024. The Author(s).)

This systematic review summarizes empirical evidence on risky decision-making (objective risk and ambiguity) in specific domains of problematic use of the internet (PUI) focusing on online addictive behaviors. We conducted a pre-registered (PROSPERO: CRD42020188452) PubMed search for PUI domains: gaming, social-network use, online buying-shopping, online pornography use, and unspecified PUI. We used the Newcastle-Ottawa Scale for quality assessment. Relevant studies were identified only for gaming (n = 19), social-network use (n = 8), unspecified PUI (n = 7), and online gambling (n = 1). The meta-analyses included 25 studies (2498 participants) comparing PUI and control groups regarding decision-making performance under objective risk and ambiguity. Across PUI domains, individuals with PUI compared to control participants showed more disadvantageous decision-making in measures of objective risk (g = -0.42 [-0.69, -0.16], p = .002) but not ambiguity (g = -0.22 [-0.47, -0.04], p = .096). PUI domain and gender were significant moderators. In the risk domain, effects were particularly present in gaming disorder, especially in exclusively male samples. Overall, the paucity of empirical studies in the considered area necessitates further research to identify probable gender- and disorder-specific cognitive relationships., Competing Interests: Competing interests SMM, EW, KI, MNP, SRC, and MB are (co-)authors of studies (n = 8) included in this review. MB, KI, and SRC are members of the “European Network for Problematic Usage of the Internet” (CA16207) supported by COST (European Cooperation in Science and Technology). KI and SRC receive honoraria from Elsevier for editorial work at Comprehensive Psychiatry (KI & SRC), and Neuroscience & Biobehavioral Reviews (SRC) journals. MNP has consulted for Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data, Baria-Tek and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support (to Yale) from Mohegan Sun Casino, Children and Screens and the Connecticut Council on Problem Gambling; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse-control disorders or other health topics; has consulted for and/or advised gambling, non-profit and legal entities on issues related to internet-use/impulse-control/addictive disorders/behaviors; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used., Methods: We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective., Findings: We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups., Interpretation: The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Social networks are frequently used to distract, procrastinate, or cope with stress. We aimed to investigate how (problematic) social-networks use affect stress perception in interaction with different stress recovery conditions. A total of 104 participants were randomly assigned to one of four groups. Three groups underwent a stress induction with subsequent stress recovery via (1) using Facebook, (2) reading magazines, or (3) waiting. Another group (4) waited without stress induction. Stress perception was repeatedly assessed with the State-Trait-Anxiety-Inventory. Facebook use and reading magazines decreased acute stress indicating adaptive coping strategies. Stress-recovery conditions and symptom severity showed significant interactions. Facebook use was not effective for individuals with high symptom severity in contrast to non-digital strategies or for individuals with low symptom severity. The usage of social networks may be an adaptive strategy for coping with stress for some people, it is maladaptive for individuals having a problematic usage., (© 2023. The Author(s).)

Implicit cognitions may be involved in the development and maintenance of specific Internet use disorders such as problematic social network use (PSNU). In more detail, implicit attitude, attentional biases, approach and avoidance tendencies as well as semantic memory associations are considered relevant in the context of PSNU. This viewpoint article summarizes the available literature on implicit cognitions in PSNU. We systematically reviewed articles of implicit cognitions in PSNU from PubMed, Scopus, Web of Science, and ProQuest databases based on a targeted search strategy and assessed using predefined inclusion and exclusion criteria. The present findings suggest that specific implicit cognitions are important in the context of PSNU and therefore show parallels to other addictive behaviors. However, the empirical evidence is limited to a few studies on this topic. Implicit cognitions in PSNU should be explored in more depth and in the context of other affective and cognitive mechanisms in future work.

Background: Studies in convenience, non-clinical samples of young adults suggest overlap between online compulsive buying-shopping disorder (OCBSD) and social-networks-use disorder (SNUD). Considering the dearth of research, this study investigated OCBSD and SNUD in clinical samples., Methods: Women with either OCBSD (n = 37) or SNUD (n = 41) were compared regarding sociodemographic variables, use time of the first-choice application, OCBSD/SNUD severity, general internet use, impulsivity, materialism, perceived chronic stress and the frequency of viewing posts of influencers and the urge to visit shopping websites or social networks after viewing influencer posts., Results: Women in the OCBSD group were older, more often employed, had less often a qualification for university entrance, indicated a lower daily use time of the first-choice application and higher materialistic values as compared to those in the SNUD group. No group differences emerged regarding general internet use, impulsivity and chronic stress. Regression models indicate that chronic stress predicted the symptom severity in the SNUD but not in the OCBSD group. The SNUD group reported a higher frequency of viewing influencer posts as compared to the OCBSD group. The urge for online shopping or using social networks after viewing influencer posts did not significantly differ between both groups., Conclusion: The findings suggest commonalities and distinct features of OCBSD and SNUD which require further investigation., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

According to the Elaborated Intrusion Theory of Desire, desire thinking and an associated deficit are fundamental factors to the emergence of craving. In the special case of problematic social networking sites (SNS) use, this experienced deficit could be constituted of an online-specific fear of missing out (FoMO). To test the interaction of these cognitions and their influence on problematic SNS use, we tested a serial mediation model on a sample of N = 193 individuals who use SNS (73% female, M age  = 28.3, SD = 9.29). We found that desire thinking predicted FoMO and both variables were only significant predictors of problematic SNS use when considered in interplay with craving. Ad hoc analyses revealed that the verbal subcomponent of desire thinking is more strongly associated with FoMO than imaginal prefiguration. Our results highlight that neither desire thinking nor FoMO are inherently dysfunctional but become problematic when they increase craving for potentially problematic SNS use., (© 2023. The Author(s).)

Background: Beyond gaming disorder and gambling disorder, pornography-use disorder, buying-shopping disorder, and social-networksuse disorders are discussed as further disorders due to addictive behaviors. For addictive behaviors, it is assumed that the experience of gratification and the experience of compensation due to the specific behavior represent reinforcing processes involved in the development and maintenance of the problematic behaviors. We aimed to develop two questionnaires that capture the experienced gratification and experienced compensation while using online activities. We additionally assume significant relationships with further addiction-related constructs such as symptom severity, use expectancies, and craving experiences., Methods: We conducted three studies for the development of the "Experience of Gratification Scale" (EGS) and the "Experience of Compensation Scale" (ECS). In each study, participants answered the questionnaires modified for their preferred online activity (gaming, gambling, buying-shopping, social-networks use, pornography use). Additional questionnaires were used, assessing further addiction-related constructs., Results: The results of the gradual approach by using exploratory and confirmatory factor analyses indicated for both scales a two-factor solution resulting in "gratification of needs" and "experience of pleasure" for the EGS, and "compensation of needs" and "experience of relief from negative feelings" for the ECS. The factors were significantly correlated with each other as well as with craving experiences, use expectancies, and symptom severity. Moreover, we found significant differences in the experienced gratification and experienced compensation for specific online behaviors., Conclusion: The theoretically plausible specific factors for experienced gratification and experienced compensation could be identified and were related to constructs considered important in addictive online behaviors. Further studies should investigate the relevance of these constructs for different types of addictive behaviors, but also within the addiction process addressing specific needs and motives as well as further positive and negative reinforcement mechanisms., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Aims: With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may also be applied to other potential specific Internet-use disorders, which may be classified in ICD-11 as other disorders due to addictive behaviors, such as online buying-shopping disorder, online pornography-use disorder, social-networks-use disorder, and online gambling disorder. Due to the heterogeneity in existing instruments, we aimed to develop a consistent and economic measure of major types of (potential) specific Internet-use disorders based on ICD-11 criteria for gaming disorder., Methods: The new 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) measures five behavioral addictions with the same set of items by following the principles of WHO's ASSIST. The ACSID-11 was administered to active Internet users (N = 985) together with an adaptation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and screeners for mental health. We used Confirmatory Factor Analyses to analyze the factor structure of ACSID-11., Results: The assumed four-factorial structure was confirmed and was superior to the unidimensional solution. This applied to gaming disorder and to the other specific Internet-use disorders. ACSID-11 scores correlated with IGDT-10 as well as with the measures of psychological distress., Discussion and Conclusions: The ACSID-11 seems to be suitable for the consistent assessment of (potential) specific Internet-use disorders based on ICD-11 diagnostic criteria for gaming disorder. The ACSID-11 may be a useful and economic instrument for studying various behavioral addictions with the same items and improving comparability.

The uncontrolled use of specific Internet applications is increasingly recognized as a mental health issue. Gaming disorder, which is one subtype of specific Internet-use disorders (sIUDs), has been included in the ICD-11 as disorder due to addictive behaviors. Addictive disorders are assumed to be accompanied by cognitive deficits as indicated by weaker performance in executive function and risky decision-making tasks. This study investigates risky decision-making in individuals with tendencies towards sIUDs including gaming, online buying-shopping, and social-networks-use disorders. A total of 293 individuals participated in the study. Based on specific screening instruments, the participants were assigned to a group with tendencies towards sIUD or a control group. Participants completed a risky decision-making task and questionnaires assessing risk-taking propensity, impulsivity, psychopathology, and perceived stress. The group with sIUD tendencies showed higher attentional impulsivity and higher levels of depression and anxiety compared to the control group. The groups did not differ in decision making and risk propensity. Decision making did not have significant effects on sIUD symptoms. Risk for developing sIUDs does not appear to be accompanied by altered general decision-making tendencies. Rather, psychological (pre-)load and attentional deficits appear to be relevant features in uncontrolled use of the Internet.

In the eleventh International Classification of Diseases (ICD-11) of the World Health Organization, gambling disorder and gaming disorder are included in the category 'disorders due to addictive behaviours', which can be specified further as occurring either predominantly offline or predominantly online. Other specific problematic behaviours may be considered for the category 'other specified disorders due to addictive behaviours'. The Research Unit FOR 2974, funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), focuses on the most prominent online addictive behaviours: gaming, pornography use, buying-shopping and social-networks use. The main goal of the Research Unit is to contribute to a better understanding of the common and differential psychological as well as neurobiological mechanisms involved in these specific types of Internet-use disorders. We aim to investigate theoretically argued (bio)psychological processes with a focus on concepts coming from research of substance-use disorders, for example, cue reactivity and craving, executive functions and specific inhibitory control, coping, implicit cognitions, and decision making. One central characteristic of the Research Unit is that we will investigate all participants using a comprehensive core battery of experimental paradigms, neuropsychological tasks, questionnaires, biomarkers, ambulatory assessment, and a 6-month follow-up survey. Beyond the anticipated contributions to the scientific understanding of the mechanisms involved in the development and maintenance of respective online addictive behaviours, we also expect contributions to clinical practice by showing which affective and cognitive mechanisms may be addressed more intensively to optimize treatment., (© 2021 The Authors. Addiction Biology published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Background: Social networking sites (SNSs) allow people to socially connect with each other, collaborate, and share information. However, problematic SNS use (PSNSU) may be associated with negative personality traits. The present study investigated the associations between PSNSU, dark triad personality traits, and emotion dysregulation., Method: In the present study, 555 SNS users (M age  = 33.32 years, SD = 10.88) completed an online survey comprising measures of PSNSU, dark triad personality traits, and emotion dysregulation., Results: Bivariate correlations showed that PSNSU was significantly associated with dark triad traits as well as emotion dysregulation. Structural equation modelling (where the effect of the dark triad traits on PSNSU was mediated by emotion dysregulation) showed that 33.5% of the variance of PSNSU was explained by Machiavellianism, psychopathy, and narcissism., Conclusion: The findings provide suggestive evidence of why PSNSU may occur as a function of the presence of dark triad traits and emotion dysregulation. The study also highlighted the important role that emotion regulation plays in the association between dark triad traits and PSNSU., (© 2021. The Author(s).)

Background and Aims: An increasing number of people experience negative consequences from the excessive use of different Internet applications or sites (e.g., Instagram, League of Legends, YouTube). These consequences have been referred to as specific Internet Use Disorders (IUDs). The present study aims to examine the Fear of Missing Out (FoMO) on rewarding experiences with respect to specific Internet activities. FoMO has been found to mediate the link between psychopathology and symptoms of Internet Communication Disorder (ICD). However, the role of FoMO in other IUDs is controversial., Methods: The current study (N = 7,990) consecutively screened in vocational schools) analyzed the associations between online-specific state-FoMO, general trait-FoMO, mental health, and IUD symptoms in a structural equation model. After testing the model for the entire sample of Internet users, it was analyzed separately for the two main user groups: Social Networking Site (SNS) users and gamers., Results: The proposed model explained 42.0% of the variance in IUD symptoms in the total sample, 46.8% for SNS users, and 32.8% for gamers. Results suggest that impaired mental health and high trait-FoMO predict IUD symptoms. For both SNS users and gamers, trait-FoMO mediated the link between low mental health and IUD, whereas state-FoMO mediated the link between trait-FoMO and IUD in both user groups., Discussion: Our results partly support the theoretical model of specific IUDs, highlighting trait-FoMO as a predisposing fear of disconnection related to general mental health. Online-specific FoMO appears to contribute to problematic Internet use mainly because of its link to the general fear of disconnection. Moreover, the described mechanism seems to be comparable for both females and males., Conclusions: FoMO is a multidimensional construct underlying IUD symptoms related to the use of socially gratifying, but distinct Internet applications. FoMO and psychopathology should be targeted together in prevention and treatment plans of IUDs.

Background and Aims: Social-networks-use disorder is discussed as a potential further type of disorders due to addictive behaviors. Theoretical models assume cue-induced craving and disadvantageous decision making to be relevant mechanisms. This study investigates if the presentation of social-networks-related cues interferes with decision making under ambiguity., Methods: Craving was induced with a cue-reactivity paradigm and assessed with a visual analogue scale. Participants (N = 146) played a modified Iowa Gambling Task with social-networks-related cues and neutral cues presented on the advantageous and disadvantageous decks respectively, or vice versa. Symptoms of social-networks-use disorder were measured with a modified version of the short Internet Addiction Test., Results: Overall, participants chose options with neutral cues more often than those with social-networks-related cues, even if it was disadvantageous. There was a significant interaction between decision-making performance and Iowa Gambling Task condition in predicting symptom severity. The results indicate that choosing decks with social-networks-related cues even if it was disadvantageous is associated with higher tendencies towards a social-networks-use disorder. The interaction with cue-induced craving did not explain further variance., Discussion and Conclusions: The results highlight the relevance of cue reactivity, decision making, and their interaction as potential mechanisms explaining tendencies towards a social-networks-use disorder. Decision making was influenced by affective responses, which could result in a higher risk of a potential addictive behavior. This is consistent with the findings from addiction research and with theoretical approaches assuming an imbalance between affective and cognitive processes in addictive behaviors.

The occurrence of the COVID-19-virus led to drastic short-term measures to reduce its spread and influence. Regulations such as "physical distancing," mentioned as "social distancing," and the closure of public facilities during the lockdown could be perceived as burdensome especially by individuals who feel a strong need for social exchange and belonging. These components such as need to belong and the fear of missing out also play a major role in the development and maintenance of a problematic use of social networks. Researchers have argued recently that an increase of addictive (online) behaviors may be a likely consequence of subjectively experienced restrictions in the context of the COVID-19 pandemic. The current study investigates the interplay of perceived strain due to COVID-19-related restrictions and the fear of missing out (FoMO) as well as of symptoms of problematic social-networks use. We hypothesized that perceived strain due to COVID-19-related restrictions mediates the effect of specific predisposing variables related to social needs on the symptom severity of a problematic use. To assess the perceived strain due to COVID-19-related restrictions, we developed a specific questionnaire asking for perceived COVID-19-related strain in several domains of everyday-life. An exploratory factor analysis identified five factors: perceived strain related to restrictions of (1) social contacts, (2) travel, (3) childcare, (4) work, and (5) own health. In a sample of 719 German participants and data collection during the first COVID-19 lockdown (March 30th until April 3rd 2020), a structural equation model was calculated showing that higher levels of need to belong and FoMO increase perceived COVID-19-related strain, which is related to symptoms of a problematic social-networks use. The effect of need to belong on problematic social-networks use is mediated by experienced COVID-19-related strain and FoMO-online. Even if the use of social networks is not pathological per se , it may be associated with suffering for a vulnerable part of users. We conclude that specific needs and fear-associated predisposing variables contribute to experiencing physical distance and other pandemic-related restrictions as more stressful, which may increase problematic social-networks use and potentially other addictive behaviors as well in the context of the COVID-19-related lockdown., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wegmann, Brandtner and Brand.)

Background: The tendency to strive for immediate gratification by neglecting potential negative long-term outcomes characterizes addictive behaviors, such as substance use or gaming disorder. Problematic social-network use is currently discussed as another potential addictive behavior, which is considered to result from an imbalance between affective and cognitive processes, indicated by traits such as increased impulsivity and/or decreased executive functions and decision-making abilities., Methods: This study investigates the respective functions in social-network users by use of the Cards and Lottery Task (CLT) - a decision-making task under risk conditions in which options contain conflicting immediate and long-term outcomes at the same time. A sample of German and Spanish participants (N = 290) performed the CLT as well as the Modified Card Sorting Test (MCST), Barratt Impulsiveness Scale (BIS), the short Internet Addiction Test specified for social-networking (sIAT-SNS), and screeners on other potentially problematic behaviors., Results: Comparing extreme groups based on sIAT-SNS scores (1SD above/below mean), individuals with problematic social-network use (n = 56), as compared to those with non-problematic social-network use (n = 50), showed increased attentional impulsivity and reduced executive functions. No differences were observed in decision-making performance., Conclusion: The findings indicate that problematic social-network use is related to attentional rather than general decision-making deficits. Furthermore, problematic social-network use is likely to co-occur with other problematic Internet-use behaviors, particularly gaming or shopping., Competing Interests: Declaration of Competing Interest none., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Aims: The present theoretical paper introduces the smartphone technology as a challenge for diagnostics in the study of Internet use disorders and reflects on the term "smartphone addiction.", Methods: Such a reflection is carried out against the background of a literature review and the inclusion of Gaming Disorder in ICD-11., Results: We believe that it is necessary to divide research on Internet use disorder (IUD) into a mobile and non-mobile IUD branch. This is important because certain applications such as the messenger application WhatsApp have originally been developed for smartphones and enfold their power and attractiveness mainly on mobile devices., Discussion and Conclusions: Going beyond the argumentation for distinguishing between mobile and non-mobile IUD, it is of high relevance for scientists to better describe and understand what persons are actually (over-)using. This is stressed by a number of examples, explicitly targeting not only the diverse contents used in the online world, but also the exact behavior on each platform. Among others, it matters if a person is more of an active producer of content or passive consumer of social media.

There exists ongoing debate regarding the clinical validity of single symptoms of and diagnostic criteria for gaming disorder. In particular, the potential symptom of gaming disorder that addresses coping with and escaping from negative feelings has received much attention and remains a focus of intensive discussion. We argue that it is important to consider differences or distinguish between, on the one hand, symptoms of and criteria for a disorder due to addictive behaviors, such as gaming disorder, versus, on the other hand, motivations, mechanisms, and psychological processes that may be involved in promoting addictive behaviors and that may explain symptom severity and course of the addictive disorder including potential treatment responses., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background and Aims: In addition to craving responses to salient food cues, the anticipation of short-term rewarding consumption of palatable food may overrun the anticipation of long-term negative consequences of obesity. The present investigation addressed the potential interplay of food cravings and decision-making abilities in individuals with obesity., Method: Study 1 included 107 bariatric surgery candidates with class 2/3 obesity (OB-group) and study 2 included 54 individuals with normal weight/pre-obesity (nonOB-group). In both studies, standardized questionnaires concerning food cravings, food addiction, and psychopathology were administered. A cue-reactivity paradigm was used to measure craving responses toward semi-individualized images of highly palatable, processed food/fruit (appetitive food cues) compared to images of raw vegetables (non-appetitive food cues). Decision-making was measured with a modified computerized version of the Iowa Gambling Task (IGT) with food pictures. Both groups were divided into two subgroups that were randomized to different IGT conditions. In one IGT condition the advantageous IGT card decks were covered by pictures of palatable, processed food or fruit and the disadvantageous decks by images of raw vegetables (= congruent condition), and in the other IGT condition vice versa ., Results: Participants in the OB-group admitted on average higher craving responses toward palatable, processed food or fruit cues compared to pictures of raw vegetables. This was not the case in the nonOB-group. Contrary to our hypothesis, decision-making performance in both groups was worse when pictures of palatable, processed food or fruit were associated with advantageous IGT card decks compared to performance when those pictures were linked to the disadvantageous decks. The interference effect of food pictures processing on advantageous decision-making has been observed particularly in those individuals of the OB-group who exhibited high craving responses toward palatable, processed food cues or high levels of food addiction., Discussion: The results indicate that food pictures processing interferes with decision-making, regardless of weight status. Opposed to the hypothesis, stronger tendencies to avoid than to approach pictures presenting processed, tasty food were observed. Further research should examine how cognitive avoidance tendencies toward processed, high energy food and approach tendencies toward healthy food can be transferred to real life situations., (Copyright © 2020 Lescher, Wegmann, Müller, Laskowski, Wunder, Jiménez-Murcia, Szycik, de Zwaan and Müller.)

Introduction: Desire thinking is a voluntary cognitive process that involves the imaginal forecast of a desired activity and the verbal perseveration with plans and good reasons for engaging in it. Considering theoretical models arguing that specific decision-making processes may be involved in the development of gaming disorder, we hypothesized that an initial urge to game might be accelerated by desire thinking, leading to the decision to game in an everyday setting although the gaming behavior may conflict with another activity or certain other goals., Methods: A pre-study helped developing a catalogue of situations that provides forced-choice scenarios warranting a decision for or against gaming. To explore the postulated sequence of cognitive and affective events, a serial mediation model with urge to game as predictor, decision to game as dependent variable, and imaginal prefiguration and verbal perseveration as mediators was tested in a sample of 118 recreational gamers with varying degrees of gaming intensity., Results: The pre-study revealed a catalogue of 18 conflicting situations that likely happen in the daily life of gamers, containing conflicting activities such as job/educational performance and meeting friends/family/acquaintances. In the sequential mediation model, the desire thinking facets imaginal prefiguration and verbal perseveration fully mediated the relation between an initial urge and the decision to game., Conclusions: The mediation model emphasizes the serial ordinance of desire thinking facets and their role in motivating decisions to game after an initial urge has been experienced. Results may indicate that desire thinking plays a considerable role in problematic gaming tendencies., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Authors.)

As a response to the COVID-19 pandemic, many governments have introduced steps such as spatial distancing and "staying at home" to curb its spread and impact. The fear resulting from the disease, the 'lockdown' situation, high levels of uncertainty regarding the future, and financial insecurity raise the level of stress, anxiety, and depression experienced by people all around the world. Psychoactive substances and other reinforcing behaviors (e.g., gambling, video gaming, watching pornography) are often used to reduce stress and anxiety and/or to alleviate depressed mood. The tendency to use such substances and engage in such behaviors in an excessive manner as putative coping strategies in crises like the COVID-19 pandemic is considerable. Moreover, the importance of information and communications technology (ICT) is even higher in the present crisis than usual. ICT has been crucial in keeping parts of the economy going, allowing large groups of people to work and study from home, enhancing social connectedness, providing greatly needed entertainment, etc. Although for the vast majority ICT use is adaptive and should not be pathologized, a subgroup of vulnerable individuals are at risk of developing problematic usage patterns. The present consensus guidance discusses these risks and makes some practical recommendations that may help diminish them., Competing Interests: Declaration of competing interest MNP, DJS, DLK, DCH, JBS, MDG, JB, MWA, HKL, HJR, ARM, SH, NAF, ZD have been members of a WHO advisory group on the public health consequences of addictive behaviors. In this capacity they have been eligible for travel support from WHO or the host center to attend advisory group meetings but have not been remunerated for their work. MNP has received financial support or compensation for the following: MNP has consulted for and advised RiverMend Health, Opiant Pharmaceuticals, Idorsia, the Addiction Policy Forum and AXA; has received research support from the Mohegan Sun Casino and the National Center for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to addictive disorders or other health topics; has consulted for or advised law offices and gambling entities on issues related to addictive disorders and behaviors; has provided clinical care in the Connecticut Department of Mental Health and Addiction Services Problem Gambling Services Program; has performed grant reviews; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts. DJS has received research grants and/or consultancy honoraria from Lundbeck and Sun. DCH receives partial salary support from the Alberta Gambling Research Institute and volunteers on the Scientific Advisory Board of the International Center for Responsible Gaming. He has received conference travel support from a variety of non-profit associations. MDG's university currently receives research funding from Norsk Tipping (the gambling operator owned by the Norwegian Government). MDG has also received funding for a number of research projects in the area of gambling education for young people, social responsibility in gambling and gambling treatment from Gamble Aware (formerly the Responsible Gambling Trust), a charitable body which funds its research program based on donations from the gambling industry. MDG regularly undertakes consultancy for various gaming companies in the area of social responsibility in gambling. SRC consults for Ieso Digital Health and Promentis; he receives stipends from Elsevier for editorial work. SRC's involvement in this research was funded by a Wellcome Trust Clinical Fellowship (110049/Z/15/Z). JBu has been working as a consultant for Cogstate, Ltd. in the past several years. JMM has received research or networking funding from several spanish official research agencies: CIBERSAM-ISCIII and AGAUR, has received consultation fees from Janssen, research funding from Janssen, AbBiotics and Medtronic, and has accepted travel grants from Servier, in the last 36 months. JZ received grants from Lundbeck, Servier, Brainsway & Pfizer, and also received honoraria or consultation fees from Servier, Pfizer, Abbott, Lilly, Actelion, AstraZeneca, SunPharma, Roche and Brainsway. He also participated at sponsored events supported by Lundbeck, Roche, Lilly, Servier, Pfizer, Abbott, SunPharma and Brainsway. SW received in the last 5 years royalities from Thieme Hogrefe, Kohlhammer, Springer, Beltz. Her work was supported in the last 5 years by the Swiss National Science Foundation (SNF), different EU FP7s, Bfarm, ZInEP, Hartmann Müller-, Olga Mayenfisch-, Gertrud Thalmann-, Vontobel-Fonds. Outside professional activities are declared under www.uzh.ch/prof/ssl-dir/interessenbindungen/client/web/. NAF has been a member of the WHO advisory group on obsessive compulsive disorders. In the past 3 years NAF has held research or networking grants from the ECNP, UK NIHR, EU H2020, MRC, University of Hertfordshire; has accepted travel and/or hospitality expenses from the BAP, ECNP, RCPsych, CINP, International Forum of Mood and Anxiety Disorders, World Psychiatric Association, Indian Association for Biological Psychiatry, Sun; has received payment from Taylor and Francis and Elsevier for editorial duties; has accepted a paid speaking engagement in a webinar sponsored by Abbott. Previously, she has accepted paid speaking engagements in various pharmaceutical industry supported symposia and has accepted grants and funding support for various pharmaceutical industry-sponsored studies in the field of OCD treatment. She leads an NHS treatment service for OCD. She holds Board membership for various registered charities linked to OCD. She gives expert advice on psychopharmacology to the UK MHRA and NICE. ZD's university receives funding from the Szerencsejáték Ltd. to maintain a telephone helpline service for problematic gambling. ZD has also been involved in research on responsible gambling founded by Szerencsejáték Ltd. and the Gambling Supervision Board., (Copyright © 2020. Published by Elsevier Inc.)

Background: Gambling and gaming disorders have been included as "disorders due to addictive behaviors" in the International Classification of Diseases (ICD-11). Other problematic behaviors may be considered as "other specified disorders due to addictive behaviors (6C5Y).", Methods: Narrative review, experts' opinions., Results: We suggest the following meta-level criteria for considering potential addictive behaviors as fulfilling the category of "other specified disorders due to addictive behaviors":1. Clinical relevance: Empirical evidence from multiple scientific studies demonstrates that the specific potential addictive behavior is clinically relevant and individuals experience negative consequences and functional impairments in daily life due to the problematic and potentially addictive behavior.2. Theoretical embedding: Current theories and theoretical models belonging to the field of research on addictive behaviors describe and explain most appropriately the candidate phenomenon of a potential addictive behavior.3. Empirical evidence: Data based on self-reports, clinical interviews, surveys, behavioral experiments, and, if available, biological investigations (neural, physiological, genetic) suggest that psychological (and neurobiological) mechanisms involved in other addictive behaviors are also valid for the candidate phenomenon. Varying degrees of support for problematic forms of pornography use, buying and shopping, and use of social networks are available. These conditions may fit the category of "other specified disorders due to addictive behaviors"., Conclusion: It is important not to over-pathologize everyday-life behavior while concurrently not trivializing conditions that are of clinical importance and that deserve public health considerations. The proposed meta-level-criteria may help guide both research efforts and clinical practice.

Adolescents nowadays spend much time communicating via social networks. Recent investigations also report a noticeable proportion showing a problematic usage behavior, underlining the importance of better understanding its development and maintenance in young individuals. Theoretical views on Internet-use disorders assume that specific predispositions and needs can contribute to addictive behaviors in interaction with further aspects including Internet-related cognitive biases. This study focuses on vulnerable individuals due to their age and investigates interactions between possible risk (need to belong, NTB) and protective factors (online self-regulative competences, OSRC). Participants ( N = 466) between 10 and 17 years answered questionnaires assessing social-networks-use disorder symptoms, NTB, and OSRC. Moderated regression analysis revealed significant effects of age, NTB, and OSRC. Three-way interaction was also significant (potentially mainly caused by females), with highest social-networks-use disorder symptoms found for individuals with high NTB and low OSRC, especially when older. With high OSRC, symptoms were significantly lower for both younger and older individuals having high NTB. However, even if NTB was low, older individuals showed high social-networks-use disorder symptoms if their OSRC were low. The results highlight the importance of improving specific competences to prevent problematic usage behaviors, which should be considered in youth-tailored prevention and intervention programs.

While the use of social media and online-communication applications has become an integral part of everyday life, some individuals suffer from an excessive, uncontrolled use of social media despite experiencing negative consequences. In accordance with neuropsychological models of addiction, we assume the tendency of a social-networks-use disorder to be related to an interplay of predisposing personality traits (e.g., impulsivity), and reductions in cognitive functions (e.g., executive functions, inhibitory control). The current study makes first strides towards examining this interplay. In addition to a newly developed social-networks-specific auditory Go-NoGo paradigm, other neuropsychological paradigms were used. Impulsivity and social-networks-use-disorder symptoms were assessed by standardized questionnaires. The results show that the symptom severity of a social-networks-use disorder is mainly associated with attentional impulsivity. General executive functions and specific inhibitory control of social-networks-related cues have no direct effect on symptom severity. However, moderated regression analyses emphasize that increased symptom severity is associated with higher attentional impulsivity, especially if there are additionally reductions in executive functions or specific inhibitory control. The results complement previous findings and inform future research on social-networks-use disorder. The findings support the applicability of theoretical models of addictive behaviors to the social-networks-use disorder and point to social-networks-related specificities regarding attention-related facets.

Background: An increasing number of studies have investigated Social Networks Use Disorder (SNUD) among Western samples. In this context, the investigation of SNUD in Asia and especially in China has been much neglected. This poses a gap in the literature; it has been estimated that more than one billion Chinese people are using Chinese social networking sites (SNSs). Of note, many of these Chinese SNSs are rather unknown to researchers in Western countries. Aims: The primary objective of the present systematic review was to identify and evaluate studies that investigated Chinese SNS use and associations between SNUD and depression and anxiety symptoms. Method: A comprehensive search strategy identified relevant studies in PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, MEDLINE, ProQuest, Web of Science, PubMed, Google Scholar, and the Chinese National Knowledge Infrastructure database (CNKI). Results: The search strategy identified 35 potential studies, 13 studies were identified after shortlisting and full-text reviews of the studies, and finally 10 studies were included in the full review. Associations between SNUD, depression, and anxiety were reported in 10 studies. In eight (of the 10) studies, symptom severity of SNUD was associated with depression. Four studies reported associations between SNUD and anxiety. Most studies had utilized cross-sectional survey designs. Conclusions: Most associations were found between SNUD and depression symptoms, but effect sizes were higher between SNUD and anxiety symptoms. The results have the potential to inform prevention and interventions on SNUD in Eastern cultures, although we explicitly state that our work focuses on China, the transfer of the present observations to other Asian countries (and their cultures) still needs to be established., (Copyright © 2020 Hussain, Wegmann, Yang and Montag.)

Background and Aims: Individuals with heroin addiction are prone to dysfunctional decision-making. They frequently choose the short-term rewarding option of drug intake despite experiencing long-term negative consequences. Opioid maintenance treatment (OMT) is the most common treatment of heroin addiction., Methods: In this study, 38 individuals in an early stage of abstinence from heroin addiction (ESA-HA individuals) at the end of inpatient detoxification treatment and 41 individuals in long-term OMT were examined. Decision-making was assessed by (I) a modified version of the Iowa Gambling Task (IGT) with drug-related stimuli focusing on decision-making under ambiguity and (II) the Game of Dice Task (GDT) assessing decision-making under objective risk., Results: OMT-individuals showed significantly better performance in the IGT than the ESA-HA-individuals. They also showed significantly less craving under exposure of drug-related pictures. In the GDT, OMT-individuals showed significantly less risky decision-making than ESA-HA-individuals., Conclusion: The results suggest that patients receiving OMT show better functional decision-making and lower craving reactions. It could be assumed that the effectiveness of OMT in preventing relapse is linked to better decision-making and lower craving among these patients., (Copyright © 2019 Elsevier B.V. All rights reserved.)