Research on behavioral addictions has flourished in the last two decades, so that a simple behavioral addiction term search in Google Scholar now yields more than 15K hits. In the emergence of this category, gambling disorder was the first non-substance addiction to be included in the DSM (DSM-5; American Psychiatric Association [APA], 2013). And, more recently, gaming disorder was included in the 11th version of the International Classification of Diseases (World Health Organization [WHO], 2019).
The basic definition of addiction was never an impediment for research on substance use disorders (SUDs). Despite the diversity of perspectives on etiological processes, research has advanced the understanding of the psychobiological, cognitive, and interpersonal processes involved in the transition from goal-driven to compulsive substance use (Hogarth, 2020, Koob and Volkow, 2016, Lüscher et al., 2020). This understanding has, in turn, resulted in an evidence-based toolbox of contingency management, psychotherapeutic, and pharmacological interventions (Ainscough et al., 2017, Bordeaux and Koob, 2023, Petry et al., 2017, Verdejo-García et al., 2019).
In contrast, the practical accomplishments of behavioral addiction research have remained more modest (King et al., 2017). In our opinion, underachievement is no longer attributable to the field’s immaturity, but to the disproportionate effort that has been dedicated to developing measures for different candidate behavioral addictions – based on extensional definitions of addiction (Sussman, 2017, Kardefelt-Winther et al., 2017) – and to then map the pattern of associations between these measures and other constructs and traits in a cross-sectional manner. This agenda has resulted in (a) a proliferation of insufficiently validated instruments for partly overlapping constructs; (b) highly disparate estimates of the incidence and prevalence of candidate behavioral addictions, and thus of the burden of disease associated with them; and (c) a proliferation of confirmatory research of questionable quality, resulting, in turn, in findings that are difficult to integrate into higher-order theoretical models. Seen from this perspective, it is unsurprising that this research rarely translates into better prevention and treatment interventions.