Authors:
Jacob S. Dinardi Department of Kinesiology, San Francisco State University, San Francisco, CA, USA

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Alexei Y. Egorov Department of Psychiatry and Addictions, Faculty of Medicine, St. Petersburg State University, St. Petersburg, Russia
Laboratory of Behaviour Neurophysiology and Pathology I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry of Russian Academy of Sciences, St. Petersburg, Russia

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Attila Szabo Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

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Abstract

Background and aims

Cited in over 100 articles, the interactional model of exercise addiction (Egorov & Szabo, 2013) forms the theoretical foundation of many studies on the risk of exercise addiction. Still, the inclusion of previously omitted determinants could make it more useful. Therefore, this review presents the expanded version of the original model.

Method

We added ‘self-concept’ as another determinant in the ‘personal factors’ domain and ‘attractive alternatives’ to the ‘situational factors’ domain. Further, we doubled the reasons for exercise in the ‘incentives for exercise domain.’ Last, we added a new domain, the ‘exercise-related stressors,’ to illustrate that exercise itself might be a source of stress.

Results

The expanded model is more inclusive and accounts for a greater combination of interactions playing roles in exercise addiction. Overlooking the eventuality that stress resulting from exercise might also fuel the dysfunction was a significant omission from the original model, rectified in the current update. Finally, the new expansions make the model more applicable to competitive situations too

Conclusion

The expanded interactional model of exercise addiction is more comprehensive than its original version. It also accounts for the exercise or sport-related stress as possible fuel in addictive exercise behavior.

Abstract

Background and aims

Cited in over 100 articles, the interactional model of exercise addiction (Egorov & Szabo, 2013) forms the theoretical foundation of many studies on the risk of exercise addiction. Still, the inclusion of previously omitted determinants could make it more useful. Therefore, this review presents the expanded version of the original model.

Method

We added ‘self-concept’ as another determinant in the ‘personal factors’ domain and ‘attractive alternatives’ to the ‘situational factors’ domain. Further, we doubled the reasons for exercise in the ‘incentives for exercise domain.’ Last, we added a new domain, the ‘exercise-related stressors,’ to illustrate that exercise itself might be a source of stress.

Results

The expanded model is more inclusive and accounts for a greater combination of interactions playing roles in exercise addiction. Overlooking the eventuality that stress resulting from exercise might also fuel the dysfunction was a significant omission from the original model, rectified in the current update. Finally, the new expansions make the model more applicable to competitive situations too

Conclusion

The expanded interactional model of exercise addiction is more comprehensive than its original version. It also accounts for the exercise or sport-related stress as possible fuel in addictive exercise behavior.

Exercise and sports are beneficial aspects of people's lives (Bushman, 2019). The World Health Organization (WHO; Bull et al., 2020) and other institutions concerned with health and human services offer guidelines on the minimum levels of physical activity individuals should engage in to receive essential health benefits. The upper threshold at which physical activity remains beneficial and is safe has not been widely reported outside of examining certain long-term effects of athletic training, for example, O'Keefe et al. (2012), nor do general guidelines presently exist for maximum levels of physical activity participation. However, an individual's exercise behavior can become maladaptive, manifesting in compulsive exercise, exercise dependence, and exercise addiction. The latter term involves both compulsion and dependence (Goodman, 1990), but they are used interchangeably in the literature to denote the same problem.

We talk about exercise addiction when significant involvement in exercise behavior adversely affects a person's health, relationships, and productivity (de la Vega, Parastatidou, Ruíz-Barquín, & Szabo, 2016; Nogueira, Molinero, Salguero, & Márquez, 2018). Moreover, exercise addiction is marked by an unhealthy obsession with physical activity leading to compulsive behavior and the inability to regulate one's involvement with exercise or sports. While cases in scholastic writings are few, Juwono and Szabo (2020) have identified 100 cases on the internet. Currently, there are no diagnostic criteria for exercise addiction. Indeed, the dysfunction is unlisted in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) due to insufficient clinical evidence.

Although this maladaptive exercise behavior has been the subject of scholarly research for over 50 years, the disorder is challenging to characterize and, therefore, it remains unclear how many individuals are affected by exercise addiction as demonstrated by widely variable rates of prevalence reported in the extant literature. Cook, Hausenblas, and Freimuth (2014) summarizes a number of studies that reported prevalence of exercise compulsion, dependence, and addiction. Furthermore, Cook et al. (2014) identifies several of the challenges that exist in measuring the prevalence of exercise addiction which include the lack of a unified theoretical approach, a focus on symptom severity over cases of fully developed exercise addiction, and differences in sample group characteristics (i.e. competitive athletes, recreational athletes, exercisers) which lead to bias in prevalence estimates.

Several proposed theoretical approaches define and assess exercise addiction, most resembling those applied in assessing substance use disorders (i.e., Hausenblas & Downs, 2002). While such approaches are valid, the underlying assumption that exercise, as an object of addiction, is analogous to drugs or alcohol in substance use disorders (SUDs) raises some questions. For instance, are mood-modification, tolerance, or withdrawal symptoms useful indices in identifying exercise addiction? Alternately, are the tools used in studying SUDs also appropriate for studying exercise addiction? Importantly, do these approaches give proper consideration to the mindsets and goals of individuals who are training with sports-related performance in mind, in addition to individuals who are exercising to improve their health or appearance? Models of substance use disorders address fundamental issues of addiction; however, they have limited potential to account for more specific exercise-related behavior such as chasing goals to achieve an idealistic physique or ideal performance. Instead of relying on SUD models in the definition of exercise addiction, it may be more beneficial to focus on factors related to sports and exercise and the people who participate in them. Conceptualizing exercise addiction as a disorder with unique antecedents, contributing factors, and consequences that set it apart from other dysfunctions, much like gambling disorder has been conceptualized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), could generate more precise ideas about what exercise addiction is and how to assess it.

Therefore, Egorov and Szabo (2013) have proposed the interactional model of exercise addiction to describe its etiology. This model describes only primary exercise addiction, which Veale (1995) describes as developing in the absence of eating disorders in contrast to secondary exercise addiction, in which certain eating disorders (i.e., anorexia, bulimia) are always present. Freimuth, Moniz, and Kim (2011) extend the concept of secondary exercise addiction by applying it to exercise behavior that is foremost motivated by the desire to relieve anxiety people experienced specifically as a result of not exercising (i.e. obsessive compulsive disorder). Whether body dysmorphic disorder should also be considered a primary disorder in the context of exercise addiction remains an open question. In brief, when a person's maladaptive exercise behavior is driven by motivation typically associated with dedicated exercise, it is considered primary exercise addiction; when the behavior is foremost driven by motivation to soothe another disorder, it is secondary exercise addiction. Thus, the model is concerned only with factors that lead an individual to be interested in exercise as an outlet for physical activity, their specific motivations, and orientations that describe their approaches in using exercise and sports to experience mastery, enhance specific elements of their life, and as means of stress-coping.

The model as originally conceptualized (Fig. 1) illustrates the pathways that individuals may come to experience exercise addiction through any of several courses. The first of these pathways results from personal and situational factors. The second results from negative stress-coping (escape), while the third recognizes that individuals' mastery orientation may drive them toward exercise addiction. The model also leaves room for the possibility that an individual can shift from exercise addiction back to healthy exercise. With this model, Egorov and Szabo have provided a comprehensive overview of antecedents of exercise and most related factors associated with the onset of exercise addiction. Still, over time, new determinants were identified, leaving room for the expansion of the model.

Fig. 1.
Fig. 1.

The interactional model of exercise addiction (Egorov & Szabo, 2013)

Citation: Journal of Behavioral Addictions 10, 3; 10.1556/2006.2021.00061

In pursuit of a better understanding of exercise addiction, we considered how the interactional model of exercise addiction may be expanded to be encompass additional factors that contribute to a person's exercise interests as well as factors inclusive of sports and training, which are often different than those strictly related to exercise and fitness. For example, the desire to enhance one's physical appearance or health are common motivations in exercise, while seeking improved sports performance, either for competitive reasons or to achieve personal goals, is associated with training (Frederick & Ryan, 1993; Reifsteck, Gill, & Labban, 2016). We posit that, among other reasons, exercise addiction has been challenging to assess because, as it is currently conceptualized, it must capture maladaptive behavior within the domain of exercise as well as the related domains of sports and training. In each of these domains, individual motivation can range widely and is constituted of different incentives as well as avoidances. While a parsimonious model is preferable in the examination of any behavior, understanding the unique courses that lead individuals into exercise addiction requires considering the broad contexts in which individuals are physically active and the distinct motivations underlying them that can become maladaptive during the exercise addiction process.

The original interactional model of exercise addiction, while comprehensive, did not consider certain factors that may play a significant role in exercising or sports becoming an unhealthy focus in a person's life. For example, among the personal factors, how people see and think about themselves could be a mediator of maladaptive exercise (Corazza et al., 2019). Choice alternatives can also influence one's gravitation toward and relationship with an activity (Lichtenstein, Christiansen, Elklit, Bilenberg, & Støving, 2014). Exercise motives also include enjoyment (Rodrigues, Teixeira, Neiva, Cid, & Monteiro, 2020), sensation seeking (Kotbagi, Morvan, Romo, & Kern, 2017), challenge (Youngman & Simpson, 2014), and less common reasons, such as strengthening family bonds (Wagoner, 2018) or exercising as an outlet to support one's sobriety and recovery from other addictions (Corbett & England, 2018). Apart from these exclusions, the original interactional model does not consider how exercise, sports, and training can become sources of stress that further fuel the addiction.

This review expands the interactional model proposed by Egorov and Szabo (2013) by adding and incorporating factors associated with the risk of exercise addiction. The original model was cited over 100 times in less than eight years and, hence, this expansion aims to broaden the research perspectives on how and why (in general) individuals become addicted to exercise.

It is beyond the scope of this review to discuss the original model, which is described in the paper by Egorov and Szabo (2013). Instead, we provide the rationale, relevance, and function for the newly included factors and a new domain. This expanded model yields a more comprehensive picture of the etiology of exercise addiction while prompting further consideration of the ways individuals' exercise habits come to be driven by addictive behavior.

The expanded interactional model of exercise addiction

The expanded model is presented in Fig. 2. It can be easily compared to the original model (Egorov & Szabo, 2013) illustrated in Fig. 1. Modified or added items are in italics in the updated model.

Fig. 2.
Fig. 2.

The expanded interactional model of exercise addiction

Citation: Journal of Behavioral Addictions 10, 3; 10.1556/2006.2021.00061

Both models include the domains of ‘personal factors’ and ‘situational factors.’ Within these domains, the factors represent personal needs and environmental influences. Although not explicitly stated in the conceptualization of the model, these factors and their interactions follow the basic concepts of the Self-Determination Theory (SDT; Deci & Ryan, 1980; Vallerand, 2000) in which a person's motivation and motivational orientation results from the interaction of personal and environmental factors. The SDT is a valuable framework for understanding motivation in exercise, sports, and training. Indeed, several studies examining exercise addiction have used SDT to explain maladaptive behavioral regulation in both sports and exercise (Edmunds, Ntoumanis, & Duda, 2006; Frederick & Ryan, 1993; González-Cutre, D., & Sicilia, 2013).

Personal and situational factors

To the domain of ‘personal factors,’ we added self-concept, which is a cognitive structure that includes ideas, attitudes, and judgments people use to make sense of the world, focus on their goals, understand their self-worth, and decide which aspects of their self are important (Leary & Tangney, 2012). Self-concept may include elements of identity (i.e., “I am an athlete”) in addition to appraisals of oneself (i.e., “I am out of shape”). This self-construction is relevant in shaping exercise behavior either positively or negatively (de la Vega et al., 2016; Reifsteck et al., 2016; Woolf & Lawrence, 2017).

To the domain of ‘situational factors,’ we have added the item ‘attractive alternatives.’ This item considers why an individual chooses to engage in sports or exercise instead of other activities; additionally, it can enhance the understanding of why someone prefers a particular form of sports or exercise over others. The situational factors listed in the model resemble those described in the Sport Commitment Model (SCM; Scanlan, Beals, Russell, & Scanlan, 2003). We added attractive alternatives as a factor found in SCM, previously not found in the original model, to encompass a broader range of situational factors and make the interactional model compatible with SCM. Although SCM was primarily applied to understand elite athletes' commitment to their sport, it is also beneficial in understanding the values and behaviors of highly committed recreational athletes and exercisers.

Incentives for exercise

The domain ‘incentives for exercise’ was presented in the original model as ‘exercise motivation’ (Fig. 1). We changed this domain's name primarily for semantic accuracy; these items represent the ways a person seeks to enhance their lived experience, their health, or physical ability, or appearance through participating in exercise and sports. We added four factors to the list, the first of which is enjoyment. Enjoyment is often the foremost reason that people exercise (Rodrigues et al., 2020). Seeking challenge is another common incentive for exercise and sports participation, particularly among individuals who participate in challenging sports and activities, such as ultradistance running, triathlon, cycling, adventure racing, and other endurance sports (Simpson, Prewitt-White, Feito, Giusti, & Shuda, 2017). People who seek challenges may feel unchallenged in other areas of their lives, disenchanted by mundane routines, or curious about finding their limits. Some individuals may also pursue risky activities to experience certain sensations such as a natural ‘high,’ transcendence, and even suffering (Nogueira et al., 2018). Flow state is yet another sensation or state of being individuals may seek out that can be experienced in different sports and activities (Csikszentmihalyi & Csikzentmihaly, 1990; Zuckerman, 2010). Further, we added the item ‘less common reasons’. Whether a person has less common reasons to participate in sports or exercise is highly personal, and examples of these reasons will likely be limited to case studies or examples from popular media such as documentaries, biographies, and personal profiles. Less common reasons for exercise may include strengthening family bonds (Wagoner, 2018), maintaining one's sobriety (Corbett & England, 2018; Wagoner, 2018), managing depression (Busch et al., 2016), supporting charitable causes (Filo, Funk, & O’Brien, 2011), and using sports as a reason for a vacation, traveling, and festival attendance (Green & Jones, 2005). With the addition of the above items, the model now encompasses a much broader range, capturing both the tangible and less tangible incentives a person might seek through exercise.

Exercise related stressors: A new domain

Finally, we added a new domain of ‘exercise-related stressors’ to the model. This domain interacts with ‘sudden or progressively intolerable stress.’ By including this concept, we recognize a significant implication of exercising. Regardless of whether a person's exercise is healthy or driven by addictive behavior, there is potential for them to experience stress due to their involvement with physical activity. Not only is this antithetical to the idea of exercising to relieve stress, but it will also necessitate additional stress-coping responses. For individuals who use exercise to escape from stress, this may result in spiraling further into a pattern of avoidance and escape, creating a dangerous circular causal relationship between physical activity and stress.

The factors we included in this domain are performance anxiety, failure to meet expectations, role conflict, and injury. In this context, performance anxiety is the unpleasant psychological state triggered by a person's perceptions that their capability is being evaluated, causing apprehension and worry (Ford et al., 2017). Performance anxiety may cause stress which can fuel an existing (exercise) addiction. Failure to meet expectations is applicable to the domains of both exercise and sports. When an individual is unable to achieve a desired level of sports performance, achieve a desired body aesthetic, or meet other expectations related to their physical activity they are likely to experience stress associated with failing to realize their desired result. Role conflict occurs when one role makes it difficult to comply with another or when the behaviors involved in one or more roles are incompatible (Tsaur, Liang, & Hsu, 2012). These conflicts arise between the roles a person takes on in sport or exercise and their family, career, education, or other vital roles in their life. The final item in this new domain is injury. Injuries in sports and exercise are common, especially during bouts of focused training, and occur from acute trauma or as the result of overuse. In either case, injuries can be stressful, particularly when they cause interruption to a person's exercise routine. All exercise-related stress sources could fuel the exercise addiction if exercise is the principal means of coping to the affected individual.

Conclusion

This expansion of the interactional model of exercise addiction by Egorov and Szabo (2013) focuses on aspects of exercise addiction associated with individuals who exercise while taking an even broader perspective on their reasons, expectations, values, and experiences related to participating in sports and exercise. We recognize that exercise and the related domains of sports and training offer a multitude of rewards, some of which are only loosely related, to individuals, and, therefore, people have broadly ranging motives for participating in exercise and sports. This multitude of incentives presents a number of potential pathways a person might come to experience exercise addiction. With this in mind, several additions were made to the original interactional model of exercise addiction to make it more comprehensive, which we view as improving the model's explanatory power.

While more extensive than its initial version, the model still leaves some key questions to be considered. For example, it cannot elucidate how a person's behavior can shift from exercise addiction to a healthy exercise pattern (forms of treatment, changes in personal or situational factors). Potential emotional factors in various domains are unaccounted for in the model. Still, the earlier model has been widely accepted and used in the exercise addiction literature. We hope that the here presented expanded model will be even more helpful.

Financial support

No financial support was received for this study.

Author contribution

JD identified the need to revise the interactional model of exercise addiction and wrote the first draft of the paper; AYE verified the theoretical connection between the dimensions of the model and ensured that the expanded model is in agreement with the literature on the topic; AS worked with JD on the expansion of the model and finalized the paper for publication.

Conflict of interest

The authors have no conflict of interest to declare.

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The author instruction is available in PDF.
Please, download the file from HERE

Dr. Zsolt Demetrovics
Institute of Psychology, ELTE Eötvös Loránd University
Address: Izabella u. 46. H-1064 Budapest, Hungary
Phone: +36-1-461-2681
E-mail: jba@ppk.elte.hu

Indexing and Abstracting Services:

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  • EBSCO
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  • CABELLS Journalytics

2022  
Web of Science  
Total Cites
WoS
5713
Journal Impact Factor 7.8
Rank by Impact Factor

Psychiatry (SCIE) 18/155
Psychiatry (SSCI) 13/144

Impact Factor
without
Journal Self Cites
7.2
5 Year
Impact Factor
8.9
Journal Citation Indicator 1.42
Rank by Journal Citation Indicator

Psychiatry 35/264

Scimago  
Scimago
H-index
69
Scimago
Journal Rank
1.918
Scimago Quartile Score Clinical Psychology Q1
Medicine (miscellaneous) Q1
Psychiatry and Mental Health Q1
Scopus  
Scopus
Cite Score
11.1
Scopus
Cite Score Rank
Clinical Psychology 10/292 (96th PCTL)
Psychiatry and Mental Health 30/531 (94th PCTL)
Medicine (miscellaneous) 25/309 (92th PCTL)
Scopus
SNIP
1.966

 

 
2021  
Web of Science  
Total Cites
WoS
5223
Journal Impact Factor 7,772
Rank by Impact Factor Psychiatry SCIE 26/155
Psychiatry SSCI 19/142
Impact Factor
without
Journal Self Cites
7,130
5 Year
Impact Factor
9,026
Journal Citation Indicator 1,39
Rank by Journal Citation Indicator

Psychiatry 34/257

Scimago  
Scimago
H-index
56
Scimago
Journal Rank
1,951
Scimago Quartile Score Clinical Psychology (Q1)
Medicine (miscellaneous) (Q1)
Psychiatry and Mental Health (Q1)
Scopus  
Scopus
Cite Score
11,5
Scopus
CIte Score Rank
Clinical Psychology 5/292 (D1)
Psychiatry and Mental Health 20/529 (D1)
Medicine (miscellaneous) 17/276 (D1)
Scopus
SNIP
2,184

2020  
Total Cites 4024
WoS
Journal
Impact Factor
6,756
Rank by Psychiatry (SSCI) 12/143 (Q1)
Impact Factor Psychiatry 19/156 (Q1)
Impact Factor 6,052
without
Journal Self Cites
5 Year 8,735
Impact Factor
Journal  1,48
Citation Indicator  
Rank by Journal  Psychiatry 24/250 (Q1)
Citation Indicator   
Citable 86
Items
Total 74
Articles
Total 12
Reviews
Scimago 47
H-index
Scimago 2,265
Journal Rank
Scimago Clinical Psychology Q1
Quartile Score Psychiatry and Mental Health Q1
  Medicine (miscellaneous) Q1
Scopus 3593/367=9,8
Scite Score  
Scopus Clinical Psychology 7/283 (Q1)
Scite Score Rank Psychiatry and Mental Health 22/502 (Q1)
Scopus 2,026
SNIP  
Days from  38
submission  
to 1st decision  
Days from  37
acceptance  
to publication  
Acceptance 31%
Rate  

2019  
Total Cites
WoS
2 184
Impact Factor 5,143
Impact Factor
without
Journal Self Cites
4,346
5 Year
Impact Factor
5,758
Immediacy
Index
0,587
Citable
Items
75
Total
Articles
67
Total
Reviews
8
Cited
Half-Life
3,3
Citing
Half-Life
6,8
Eigenfactor
Score
0,00597
Article Influence
Score
1,447
% Articles
in
Citable Items
89,33
Normalized
Eigenfactor
0,7294
Average
IF
Percentile
87,923
Scimago
H-index
37
Scimago
Journal Rank
1,767
Scopus
Scite Score
2540/376=6,8
Scopus
Scite Score Rank
Cllinical Psychology 16/275 (Q1)
Medicine (miscellenous) 31/219 (Q1)
Psychiatry and Mental Health 47/506 (Q1)
Scopus
SNIP
1,441
Acceptance
Rate
32%

 

Journal of Behavioral Addictions
Publication Model Gold Open Access
Submission Fee none
Article Processing Charge 990 EUR/article for articles submitted after 30 April 2023 (850 EUR for articles submitted prior to this date)
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
World Bank Low-income economies: 100%
Further Discounts Corresponding authors, affiliated to an EISZ member institution subscribing to the journal package of Akadémiai Kiadó: 100%.
Subscription Information Gold Open Access

Journal of Behavioral Addictions
Language English
Size A4
Year of
Foundation
2011
Volumes
per Year
1
Issues
per Year
4
Founder Eötvös Loránd Tudományegyetem
Founder's
Address
H-1053 Budapest, Hungary Egyetem tér 1-3.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2062-5871 (Print)
ISSN 2063-5303 (Online)

Senior editors

Editor(s)-in-Chief: Zsolt DEMETROVICS

Assistant Editor(s): Csilla ÁGOSTON

Associate Editors

  • Stephanie ANTONS (Universitat Duisburg-Essen, Germany)
  • Joel BILLIEUX (University of Lausanne, Switzerland)
  • Beáta BŐTHE (University of Montreal, Canada)
  • Matthias BRAND (University of Duisburg-Essen, Germany)
  • Ruth J. van HOLST (Amsterdam UMC, The Netherlands)
  • Daniel KING (Flinders University, Australia)
  • Gyöngyi KÖKÖNYEI (ELTE Eötvös Loránd University, Hungary)
  • Ludwig KRAUS (IFT Institute for Therapy Research, Germany)
  • Marc N. POTENZA (Yale University, USA)
  • Hans-Jurgen RUMPF (University of Lübeck, Germany)

Editorial Board

  • Sophia ACHAB (Faculty of Medicine, University of Geneva, Switzerland)
  • Alex BALDACCHINO (St Andrews University, United Kingdom)
  • Judit BALÁZS (ELTE Eötvös Loránd University, Hungary)
  • Maria BELLRINGER (Auckland University of Technology, Auckland, New Zealand)
  • Henrietta BOWDEN-JONES (Imperial College, United Kingdom)
  • Damien BREVERS (University of Luxembourg, Luxembourg)
  • Wim VAN DEN BRINK (University of Amsterdam, The Netherlands)
  • Julius BURKAUSKAS (Lithuanian University of Health Sciences, Lithuania)
  • Gerhard BÜHRINGER (Technische Universität Dresden, Germany)
  • Silvia CASALE (University of Florence, Florence, Italy)
  • Luke CLARK (University of British Columbia, Vancouver, B.C., Canada)
  • Jeffrey L. DEREVENSKY (McGill University, Canada)
  • Geert DOM (University of Antwerp, Belgium)
  • Nicki DOWLING (Deakin University, Geelong, Australia)
  • Hamed EKHTIARI (University of Minnesota, United States)
  • Jon ELHAI (University of Toledo, Toledo, Ohio, USA)
  • Ana ESTEVEZ (University of Deusto, Spain)
  • Fernando FERNANDEZ-ARANDA (Bellvitge University Hospital, Barcelona, Spain)
  • Naomi FINEBERG (University of Hertfordshire, United Kingdom)
  • Sally GAINSBURY (The University of Sydney, Camperdown, NSW, Australia)
  • Belle GAVRIEL-FRIED (The Bob Shapell School of Social Work, Tel Aviv University, Israel)
  • Biljana GJONESKA (Macedonian Academy of Sciences and Arts, Republic of North Macedonia)
  • Marie GRALL-BRONNEC (University Hospital of Nantes, France)
  • Jon E. GRANT (University of Minnesota, USA)
  • Mark GRIFFITHS (Nottingham Trent University, United Kingdom)
  • Joshua GRUBBS (University of New Mexico, Albuquerque, NM, USA)
  • Anneke GOUDRIAAN (University of Amsterdam, The Netherlands)
  • Susumu HIGUCHI (National Hospital Organization Kurihama Medical and Addiction Center, Japan)
  • David HODGINS (University of Calgary, Canada)
  • Eric HOLLANDER (Albert Einstein College of Medicine, USA)
  • Zsolt HORVÁTH (Eötvös Loránd University, Hungary)
  • Susana JIMÉNEZ-MURCIA (Clinical Psychology Unit, Bellvitge University Hospital, Barcelona, Spain)
  • Yasser KHAZAAL (Geneva University Hospital, Switzerland)
  • Orsolya KIRÁLY (Eötvös Loránd University, Hungary)
  • Chih-Hung KO (Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan)
  • Shane KRAUS (University of Nevada, Las Vegas, NV, USA)
  • Hae Kook LEE (The Catholic University of Korea, Republic of Korea)
  • Bernadette KUN (Eötvös Loránd University, Hungary)
  • Katerina LUKAVSKA (Charles University, Prague, Czech Republic)
  • Giovanni MARTINOTTI (‘Gabriele d’Annunzio’ University of Chieti-Pescara, Italy)
  • Gemma MESTRE-BACH (Universidad Internacional de la Rioja, La Rioja, Spain)
  • Astrid MÜLLER (Hannover Medical School, Germany)
  • Daniel Thor OLASON (University of Iceland, Iceland)
  • Ståle PALLESEN (University of Bergen, Norway)
  • Afarin RAHIMI-MOVAGHAR (Teheran University of Medical Sciences, Iran)
  • József RÁCZ (Hungarian Academy of Sciences, Hungary)
  • Michael SCHAUB (University of Zurich, Switzerland)
  • Marcantanio M. SPADA (London South Bank University, United Kingdom)
  • Daniel SPRITZER (Study Group on Technological Addictions, Brazil)
  • Dan J. STEIN (University of Cape Town, South Africa)
  • Sherry H. STEWART (Dalhousie University, Canada)
  • Attila SZABÓ (Eötvös Loránd University, Hungary)
  • Hermano TAVARES (Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil)
  • Alexander E. VOISKOUNSKY (Moscow State University, Russia)
  • Aviv M. WEINSTEIN (Ariel University, Israel)
  • Anise WU (University of Macau, Macao, China)

 

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