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Jesús Castro-Calvo Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain

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Maèva Flayelle Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland

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José C. Perales Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain

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Matthias Brand General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany

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Marc N. Potenza Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, CT, USA
Department of Neuroscience and the Wu Tsai Institute, Yale University, New Haven, CT, USA
Connecticut Mental Health Center, New Haven, CT, USA
The Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA

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Joël Billieux Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland

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Open access

Abstract

The paper by Sassover and Weinstein (2022) contributes to a timely and complex debate related to the classification of Compulsive Sexual Behavior Disorder (CSBD). The recent inclusion of CSBD as an impulse-control disorder in the ICD-11 has generated debate since a competitive view is that CSBD should rather be classified as an addictive disorder. Sassover and Weinstein (2022) reviewed existing evidence and concluded it does not support the conceptualization of CSBD as an addictive disorder. Although we agree regarding the relevance and timely nature of considering the classification of CSBD, we respectfully disagree with the position that relying on the components model of addiction (Griffiths, 2005) is the optimal approach for determining whether or not CSBD is an addictive disorder. In this commentary, we discuss potential pitfalls of relying on the components model to conceptualize CSBD as an addictive disorder and argue that considering a process-based approach is important for advancing this timely debate.

Abstract

The paper by Sassover and Weinstein (2022) contributes to a timely and complex debate related to the classification of Compulsive Sexual Behavior Disorder (CSBD). The recent inclusion of CSBD as an impulse-control disorder in the ICD-11 has generated debate since a competitive view is that CSBD should rather be classified as an addictive disorder. Sassover and Weinstein (2022) reviewed existing evidence and concluded it does not support the conceptualization of CSBD as an addictive disorder. Although we agree regarding the relevance and timely nature of considering the classification of CSBD, we respectfully disagree with the position that relying on the components model of addiction (Griffiths, 2005) is the optimal approach for determining whether or not CSBD is an addictive disorder. In this commentary, we discuss potential pitfalls of relying on the components model to conceptualize CSBD as an addictive disorder and argue that considering a process-based approach is important for advancing this timely debate.

Introduction

The publication by Sassover & Weinstein (2022) contributes to a timely discussion regarding the classification of Compulsive Sexual Behavior Disorder (CSBD). Its recent inclusion as an impulse-control disorder in the ICD-11 has been debated (Gola & Potenza, 2018a; Potenza, Gola, Voon, Kor, & Kraus, 2017), since a competitive view is that CSBD should rather be classified as an addictive disorder. The conceptualization of CSBD within an addiction framework has been discussed for decades (Orford, 1978), and this debate intensified with the release of the DSM-5, when CSBD – operationalized as “Hypersexual Disorder” – was not included (Reid & Kafka, 2014). Since then, and given emerging data, there has been increasing consideration of conceptualizing CSBD as an addictive disorder (Kor, Fogel, Reid, & Potenza, 2013; Kowalewska et al., 2018; Kraus, Voon, & Potenza, 2016; Stark, Klucken, Potenza, Brand, & Strahler, 2018). The inclusion of CSBD in the ICD-11 (Kraus, Krueger, et al., 2018) advanced nosological debates regarding CSBD (e.g., Brand et al., 2022). The multiple potentially conflicting conceptualizations of CSBD may complicate its clinical diagnosis, as well as research efforts (e.g., estimating the prevalence of CSBD in population-based epidemiological studies or national databases [Kraus et al., 2016]).

In this context, Sassover & Weinstein (2022) reviewed existing evidence, and concluded it does not support the conceptualization of CSBD as an addictive disorder. In reaching this conclusion, the authors relied on the components model of addiction (Griffiths, 2005) to determine whether symptomatic features of CSBD match traditional diagnostic criteria for addictive disorders. Here, we contend that considering a process-based approach is important when classifying CSBD.

Potential pitfalls of relying on the components model of addiction

The components model of addiction (Griffiths, 2005) posits that excessive/interfering behavioral engagement (such as in CSBD) needs to display six co-occurring symptomatic features (i.e., salience, mood modification, tolerance, withdrawal, conflict, and relapse) to be conceptualized as addictive. A main pitfall of such a perspective is that certain components, characteristic of substance-use disorders (SUDs), may not be valid when considering non-substance-related addictive behaviors (Billieux, Schimmenti, Khazaal, Maurage, & Heeren, 2015; Flayelle, Schimmenti, Starcevic, & Billieux, 2022; Starcevic, Billieux, & Schimmenti, 2018). This appears particularly relevant for tolerance and withdrawal, which may have limited clinical relevance for non-substance-related addictive behaviors (Castro-Calvo, King, et al., 2021; Starcevic, 2016). For example, tolerance in the context of gambling, gaming, or sexual behaviors has frequently been operationalized as escalations in various behavioral aspects (e.g., time spent, frequency, intensity, type of contents) to achieve desired effects (King, Herd, & Delfabbro, 2017). Similarly, withdrawal symptoms are often described as aversive emotional states (e.g., irritability, anxiety, moodiness) arising from not engaging in the behavior (i.e., following abstinence [Kaptsis, King, Delfabbro, & Gradisar, 2016]). As an illustration, Sassover & Weinstein (2022)) based their review on specific articles including debatable and not necessarily valid proxies of tolerance, such as “time spent on sexual activity” or “pursuit of new sexual partners” (e.g., Coleman-Kennedy & Pendley, 2002). However, these aspects also vary according to multiple factors (e.g., oscillations of sexual desire [Hällström & Samuelsson, 1990], mood [Bancroft et al., 2003], relationship development [Birnbaum, 2018], transient changes of hormonal levels [Bancroft, 2005], normal habituation of sexual arousal [Over & Koukounas, 1995]), thus not necessarily reflecting tolerance per se. Furthermore, the frequency of pornography use may neither be an appropriate indicator to distinguish problematic from non-problematic engagement (Bőthe, Tóth-Király, Potenza, Orosz, & Demetrovics, 2020) nor a significant predictor of treatment-seeking for problematic pornography use (Gola, Lewczuk, & Skorko, 2016). Therefore, equating an increase in the frequency or characteristics of the sexual activity with tolerance does not appropriately consider the multiple biopsychosocial factors potentially promoting escalations of sexual behavior, which may be relatively distinct from or peripheral to addictions. A similar reasoning is applicable regarding withdrawal. Instead of an addiction feature, negative emotional states (e.g., anxiety, irritation, low mood) following the cessation of sexual behaviors that are often considered a consequence of withdrawal (Fernandez, Kuss, & Griffiths, 2021) may be better understood as normal psychological reactions to sexual deprivation.

Sassover & Weinstein (2022) concluded that current evidence does not support the existence of CSBD-related tolerance and withdrawal. Yet, a major issue is that, based on the rationale adopted by the authors (i.e., using the components model of addiction as decisional criteria), such a lack of evidence is sufficient to dismiss this condition as an addictive behavior, as “all these components need to be present for a behaviour to be operationally defined as addictive” (Griffiths, 2005, p. 195), while tolerance and withdrawal criteria may not be particularly relevant to CSBD and, more generally, to non-substance-related addictive behaviors. The same consideration relates to mood modification, which is involved in substance and non-substance-related addictions but also in many other mental health conditions (e.g., obsessive-compulsive-related disorders) and may be considered a process involved in the development and maintenance of addictive (and other) disorders and not a core symptom (Brand, Rumpf, King, Potenza, & Wegmann, 2020).

Another potentially problematic aspect of the components model of addiction is the assumption that, besides their co-occurrence, all components are considered of equal weight in terms of their diagnostic value. In the context of gaming disorder, data have challenged this notion by showing that, while some components constitute “core criteria” (i.e., key symptoms for diagnosis), others constitute “peripheral criteria” (i.e., symptoms also typically presented by highly yet healthily engaged gamers) (Charlton & Danforth, 2007, 2009). This distinction (i.e., non-problematic vs. problematic gaming), crucial for ensuring the validity and utility of the diagnosed condition (Billieux, Flayelle, Rumpf, & Stein, 2019), resonates with the terms “diagnostic validity” and “clinical utility” (Jablensky, 2016). Diagnostic validity refers to the extent to which a criterion is a feature of a condition (matching the above definition of a peripheral criterion), whereas clinical utility refers to the extent to which a criterion can distinguish normal/healthy from problematic behaviors (thus constituting a core criterion). A recent Delphi study involving an international panel of experts on gaming disorder concluded that symptoms derived from the components model of addiction, such as withdrawal, tolerance, or mood modification, lack clinical utility (i.e., are not able to distinguish highly engaged but non-problematic from problematic gamers) (Castro-Calvo, King et al., 2021), thus implying that they should not be used to diagnose the condition. Although past research supports the view that frequent involvement in activities such as consuming pornography is not necessarily problematic (e.g., Kraus, Sturgeon, & Potenza, 2018), and that certain symptoms (e.g., diminished/lost control, continued engagement despite interference) may constitute core criteria of CSBD (Castro-Calvo, Gil-Llario, Giménez-García, Gil-Juliá, & Ballester-Arnal, 2020; Knight & Du, 2021; Werner, Štulhofer, Waldorp, & Jurin, 2018), evidence supporting potential distinctions between “core” and “peripheral” criteria is still scarce for CSBD. Therefore, elucidating the diagnostic validity and clinical utility of specific symptoms used to define CSBD (especially those mimicking SUDs) warrants further research (Bőthe, Lonza, Štulhofer, & Demetrovics, 2020).

Finally, the components model assumes that symptomatic similarities between SUDs and addictive behaviors such as those in gambling or gaming disorders may derive from common etiological mechanisms. Although appealing due to its simplicity and apparent validity, this approach has a considerable limitation in that the same symptom may arise from different mechanisms (Brand et al., 2022). Accordingly, placing exclusive focus on symptoms may neglect underlying cognitive, psychological, and learning processes that may account for the initiation and/or maintenance of addictive behaviors, which may warrant targeting in treatment (Billieux, Philippot, et al., 2015). As opposed to a symptom-focused approach, alternative theoretical models and hypotheses have been proposed for characterizing CSBD (Walton, Cantor, Bhullar, & Lykins, 2017), although most still require empirical validation (Gola & Potenza, 2018b). Consistent with contemporary approaches to the conceptualization of addictive behaviors (e.g., Brand et al., 2019; Perales et al., 2020), we argue that considering a process-based perspective will help elucidate whether or not CSBD may be best conceptualized within an addiction framework.

On the relevance of considering a process-based approach

Recently, studies have been investigating similarities between CSBD, SUDs, and recognized behavioral addictions (e.g., gambling disorder) beyond symptom-level analyses, such as exploring common neural and psychological processes (e.g., Castro-Calvo, Ballester-Arnal, Gil-Llario, & Giménez-García, 2016; Stark et al., 2018; Yip et al., 2018). Such data may identify similarities, although these would not unequivocally mean that such processes contribute mechanistically identically to SUDs and gambling or gaming disorders (Perales et al., 2020). The conceptualization of CSBD as a potential addictive disorder would benefit from identification of specific processes leading to the initiation and maintenance of CSBD to evaluate their compatibility with an addiction framework.

From a process-based perspective, Perales et al. (2020, p. 772) proposed that “the addictive process can be defined as a transition between behavioral control modes”, which consist in goal-directed and stimulus-driven modes (akin to “liking” and “wanting” systems of the incentive sensitization theory [Robinson & Berridge, 2001], or “model-based” and “model-free” control from the reinforcement learning model [O'Doherty, Cockburn, & Pauli, 2017]). Should the pathogenesis of addictive behaviors imply a dynamic transition between control modes, exploring potentially “static” etiological factors associated with CSBD (such as neurobiological and/or dispositional underpinnings) may provide limited insight regarding involved etiological processes. Rather, research efforts focusing on identifying learning-induced and psychobiological changes underlying such transitions, while also considering the stage of the addiction process, may provide important insights. According to Perales et al. (2020), two processes are of crucial importance to define addictive behaviors: (1) domain-specific compulsivity and (2) relative outcome utility.

Domain-specific compulsivity refers to diminished or ”lost” control contributing to the experience of being “forced” or “compelled” to act despite related negative consequences (Yücel et al., 2019). The incremental contribution of domain-specific compulsivity might progressively overcome the one of other central constructs in addictive disorders, such as impulsivity. Therefore, exploring the longitudinal evolution of compulsivity throughout the addiction pathogenesis, and delineating the differential contribution of compulsivity versus impulsivity, could help to elucidate whether CSBD should be conceptualized as an impulse-control or addictive disorder.

In contrast, relative outcome utility refers to the efficiency of a certain behavior for obtaining positive and/or negative reinforcement, compared to alternative behaviors. By means of this mechanism, a specific behavior grows more likely to become problematic when it is the only (or most efficient) strategy to achieve a particular outcome (e.g., obtaining sexual pleasure, reducing discomfort). While the relevance of this mechanism has been recognized in models of problematic internet use (Kardefelt-Winther, 2014), evidence regarding CSBD remains scarce. Addressing the relevance of such a framework for characterizing CSBD requires an in-depth understanding of specific motives underlying dysfunctional engagement in sexual behaviors. Preliminary studies in this area seem to offer promising results (e.g., Castro-Calvo, Giménez-García, Gil-Llario, & Ballester-Arnal, 2018; Koós, Fuss, Klein, Demetrovics, & Bőthe, 2021), but further research is required before considering relative outcome utility central to CSBD and its classification as an addictive disorder.

Beyond this framework, other types of evidence, largely ignored by Sassover & Weinstein (2022), should be considered to determine whether or not CSBD should be viewed as an addictive disorder, including (but not limited to) experimental and clinical findings emphasizing roles of specific affective (e.g., cue-reactivity and craving) and cognitive processes (e.g., attentional bias, inhibitory control, cognitive flexibility, decision making-related mechanisms) in CSBD's development and maintenance (Brand et al., 2019). A recent systematic review addressing this topic notably concluded that problematic use of pornography is characterized by marked attentional biases toward sexual stimuli, deficient inhibitory control, worse performance in tasks assessing working memory, and decision-making impairments (Castro-Calvo, Cervigón-Carrasco, Ballester-Arnal, & Giménez-García, 2021), a pattern of cognitive biases commonly observed in patients presenting with SUDs (Kluwe-Schiavon et al., 2020), gaming disorder (Billieux et al., 2020), and other behavioral addictions (Wegmann & Brand, 2020).

In sum, solely relying on the components model of addiction to determine whether or not CSBD should be conceptualized as an addictive disorder, as per the approach adopted by Sassover & Weinstein (2022), is problematic because (1) some components of this model (e.g., tolerance) may not distinguish disordered from intensive yet nonproblematic sexual behaviors, and (2) it largely ignores potential etiological mechanisms from a process-based perspective. For the moment, the clinical applicability of this process-based perspective is limited, but we believe that research efforts advancing knowledge on these mechanisms may contribute to the classification of CSBD and the development of more accurate diagnostic and treatment approaches.

Funding sources

No financial support was received for the preparation of this commentary.

Authors' contribution

JCC and JB wrote the first draft of the commentary. All authors contributed to and have approved the final version of the paper.

Conflict of interest

The authors report no conflicts of interest with respect to the content of this manuscript. MB receives funding (to University of Duisburg-Essen) from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) for the Research Unit ACSID, FOR2974 – 411232260. MNP has consulted for and advised Game Day Data, the Addiction Policy Forum, AXA, Idorsia and Opiant/Lakelight Therapeutics; has been involved in a patent application with Yale University and Novartis; received research support from the Veteran's Administration, Mohegan Sun Casino and the National Center for Responsible Gaming (now the International Center for Responsible Gaming); participated in surveys, mailings, or telephone consultations related to drug addiction, impulse-control disorders, or other health topics; consulted for law offices, the federal public defender's office and gambling entities on issues related to impulse-control and addictive disorders; provided clinical care in the Connecticut Department of Mental Health and Addiction Services Problem Gambling Services Program; performed grant reviews for the National Institutes of Health and other agencies; edited journals and journal sections; given academic lectures in grand rounds, CME events, and other clinical/scientific venues; and generated books or chapters for publishers of mental health texts. MB, MNP, and JB are associate editors of Journal of Behavioral Addictions. The other authors (JCC, MF, and JCP) report no disclosures. The views presented in this manuscript represent those of the authors and not necessarily those of the funding agencies.

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  • Kor, A. , Fogel, Y. , Reid, R. C. , & Potenza, M. N. (2013). Should hypersexual disorder be classified as an addiction? Sexual Addiction & Compulsivity, 20(1–2). https://doi.org/10.1080/10720162.2013.768132.

    • Search Google Scholar
    • Export Citation
  • Kowalewska, E. , Grubbs, J. B. , Potenza, M. N. , Gola, M. , Draps, M. , & Kraus, S. W. (2018). Neurocognitive mechanisms in compulsive sexual behavior disorder. Current Sexual Health Reports, 10, 255264. https://doi.org/10.1007/s11930-018-0176-z.

    • Search Google Scholar
    • Export Citation
  • Kraus, S. W. , Krueger, R. B. , Briken, P. , First, M. B. , Stein, D. J. , Kaplan, M. S. , … Reed, G. M. (2018). Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry, 17(1), 109110. https://doi.org/10.1002/wps.20499.

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    • Search Google Scholar
    • Export Citation
  • Kraus, S. W. , Sturgeon, J. A. , & Potenza, M. N. (2018). Specific forms of passionate attachment differentially mediate relationships between pornography use and sexual compulsivity in young adult men. Sexual Addiction and Compulsivity, 25(4), 380395. https://doi.org/10.1080/10720162.2018.1532362.

    • Search Google Scholar
    • Export Citation
  • Kraus, S. W. , Voon, V. , & Potenza, M. N. (2016). Should compulsive sexual behavior be considered an addiction? Addiction, 111(12), 20972106. https://doi.org/10.1111/add.13297.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O’Doherty, J. P. , Cockburn, J. , & Pauli, W. M. (2017). Learning, reward, and decision making. Annual Review of Psychology, 68, 73. https://doi.org/10.1146/ANNUREV-PSYCH-010416-044216.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Orford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal of Addiction, 73(3), 299310. https://doi.org/10.1111/j.1360-0443.1978.tb00157.x.

    • Search Google Scholar
    • Export Citation
  • Over, R. , & Koukounas, E. (1995). Habituation of sexual arousal: Product and process. Annual Review of Sex Research, 6(1), 187223. https://doi.org/10.1080/10532528.1995.10559905.

    • Search Google Scholar
    • Export Citation
  • Perales, J. C. , King, D. L. , Navas, J. F. , Schimmenti, A. , Sescousse, G. , Starcevic, V. , … Billieux, J. (2020). Learning to lose control: A process-based account of behavioral addiction. Neuroscience and Biobehavioral Reviews, 108, 771780. https://doi.org/10.1016/j.neubiorev.2019.12.025.

    • PubMed
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    • Export Citation
  • Potenza, M. N. , Gola, M. , Voon, V. , Kor, A. , & Kraus, S. W. (2017). Is excessive sexual behaviour an addictive disorder? The Lancet Psychiatry, 4(9), 663664. https://doi.org/10.1016/S2215-0366(17)30316-4.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Reid, R. C. , & Kafka, M. P. (2014). Controversies about hypersexual disorder and the DSM-5. Current Sexual Health Reports, 6(4), 259264. https://doi.org/10.1007/s11930-014-0031-9.

    • Search Google Scholar
    • Export Citation
  • Robinson, T. E. , & Berridge, K. C. (2001). Incentive-sensitization and addiction. Addiction, 96(1), 103114. https://doi.org/10.1046/j.1360-0443.2001.9611038.x.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Sassover, E. , & Weinstein, A. (2022). Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view. Journal of Behavioral Addictions, 11(2), 166179. https://doi.org/10.1556/2006.2020.00055.

    • Search Google Scholar
    • Export Citation
  • Starcevic, V. (2016). Tolerance and withdrawal symptoms may not be helpful to enhance understanding of behavioural addictions. Addiction, 111(7), 13071308. https://doi.org/10.1111/add.13381.

    • Search Google Scholar
    • Export Citation
  • Starcevic, V. , Billieux, J. , & Schimmenti, A. (2018). Selfitis, selfie addiction, Twitteritis: Irresistible appeal of medical terminology for problematic behaviours in the digital age. Australian and New Zealand Journal of Psychiatry, 52(5), 408409. https://doi.org/10.1177/0004867418763532.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Stark, R. , Klucken, T. , Potenza, M. N. , Brand, M. , & Strahler, J. (2018). A current understanding of the behavioral neuroscience of compulsive sexual behavior disorder and problematic pornography use. Current Behavioral Neuroscience Reports, 5(4), 218231. https://doi.org/10.1007/s40473-018-0162-9.

    • Search Google Scholar
    • Export Citation
  • Walton, M. T. , Cantor, J. M. , Bhullar, N. , & Lykins, A. D. (2017). Hypersexuality: A critical review and introduction to the “Sexhavior cycle”. Archives of Sexual Behavior, 46, 22312251. https://doi.org/10.1007/s10508-017-0991-8.

    • Search Google Scholar
    • Export Citation
  • Wegmann, E. , & Brand, M. (2020). Cognitive correlates in gaming disorder and social networks use disorder: A comparison. Current Addiction Reports, 7(3), 356364. https://doi.org/10.1007/s40429-020-00314-y.

    • Search Google Scholar
    • Export Citation
  • Werner, M. , Štulhofer, A. , Waldorp, L. , & Jurin, T. (2018). A network approach to hypersexuality: Insights and clinical implications. Journal of Sexual Medicine, 15(3), 410415. https://doi.org/10.1016/j.jsxm.2018.01.009.

    • Search Google Scholar
    • Export Citation
  • Yip, S. W. , Worhunsky, P. D. , Xu, J. , Morie, K. P. , Constable, R. T. , Malison, R. T. , … Potenza, M. N. (2018). Gray-matter relationships to diagnostic and transdiagnostic features of drug and behavioral addictions. Addiction Biology, 23(1), 394402. https://doi.org/10.1111/ADB.12492.

    • PubMed
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    • Export Citation
  • Yücel, M. , Oldenhof, E. , Ahmed, S. H. , Belin, D. , Billieux, J. , Bowden-Jones, H. , … Verdejo-Garcia, A. (2019). A transdiagnostic dimensional approach towards a neuropsychological assessment for addiction: An international Delphi consensus study. Addiction, 114(6), 10951109. https://doi.org/10.1111/add.14424.

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  • Billieux, J. , Flayelle, M. , Rumpf, H.-J. , & Stein, D. J. (2019). High involvement versus pathological involvement in video games: A crucial distinction for ensuring the validity and utility of gaming disorder. Current Addiction Reports, 6(3), 323330. https://doi.org/10.1007/s40429-019-00259-x.

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  • Billieux, J. , Philippot, P. , Schmid, C. , Maurage, P. , De Mol, J. , & Van der Linden, M. (2015). Is dysfunctional use of the mobile phone a behavioural addiction? Confronting symptom-based versus process-based approaches. Clinical Psychology & Psychotherapy, 22(5), 460468. https://doi.org/10.1002/CPP.1910.

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  • Billieux, J. , Potenza, M. N. , Maurage, P. , Brevers, D. , Brand, M. , & King, D. L. (2020). Cognitive factors associated with gaming disorder. In A. Verdejo-Garcia (Ed.), Cognition and addiction (pp. 221230). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-12-815298-0.00016-2.

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  • Billieux, J. , Schimmenti, A. , Khazaal, Y. , Maurage, P. , & Heeren, A. (2015). Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Journal of Behavioral Addictions, 4(3), 119123. https://doi.org/10.1556/2006.4.2015.009.

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  • Birnbaum, G. E. (2018). The fragile spell of desire: A functional perspective on changes in sexual desire across relationship development. Personality and Social Psychology Review, 22(2), 101127. https://doi.org/10.1177/1088868317715350.

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  • Bőthe, B. , Lonza, A. , Štulhofer, A. , & Demetrovics, Z. (2020). Symptoms of problematic pornography use in a sample of treatment considering and treatment non-considering men: A network approach. Journal of Sexual Medicine, 17(10), 20162028. https://doi.org/10.1016/j.jsxm.2020.05.030.

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  • Bőthe, B. , Tóth-Király, I. , Potenza, M. N. , Orosz, G. , & Demetrovics, Z. (2020). High-frequency pornography use may not always be problematic. The Journal of Sexual Medicine, 17(4), 793811. https://doi.org/10.1016/j.jsxm.2020.01.007.

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  • Brand, M. , Rumpf, H. , Demetrovics, Z. , Müller, A. , Stark, R. , King, D. L. , … Potenza, M. N. (2022). Which conditions should be considered as disorders in the International Classification of Diseases (ICD-11) designation of “other specified disorders due to addictive behaviors”? Journal of Behavioral Addictions, 11(2), 150159. https://doi.org/10.1556/2006.2020.00035.

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  • Brand, M. , Rumpf, H. J. , King, D. L. , Potenza, M. N. , & Wegmann, E. (2020). Clarifying terminologies in research on gaming disorder and other addictive behaviors: Distinctions between core symptoms and underlying psychological processes. Current Opinion in Psychology, 36, 4954. https://doi.org/10.1016/j.copsyc.2020.04.006.

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  • Brand, M. , Wegmann, E. , Stark, R. , Müller, A. , Wölfling, K. , Robbins, T. W. , & Potenza, M. N. (2019). The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neuroscience and Biobehavioral Reviews, 104, 110. https://doi.org/10.1016/j.neubiorev.2019.06.032.

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  • Castro-Calvo, J. , Cervigón-Carrasco, V. , Ballester-Arnal, R. , & Giménez-García, C. (2021). Cognitive processes related to problematic pornography use (PPU): A systematic review of experimental studies. Addictive Behaviors Reports, 13. https://doi.org/10.1016/j.abrep.2021.100345.

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  • Castro-Calvo, J. , Gil-Llario, M. D. , Giménez-García, C. , Gil-Juliá, B. , & Ballester-Arnal, R. (2020). Ocurrence and clinical characteristics of compulsive sexual behavior disorder (CSBD): A cluster analysis in two independent community samples. Journal of Behavioral Addictions, 9(12), 446468. https://doi.org/10.1556/2006.2020.00025.

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  • Castro-Calvo, J. , King, D. L. , Stein, D. J. , Brand, M. , Carmi, L. , Chamberlain, S. R. , … Billieux, J. (2021). Expert appraisal of criteria for assessing gaming disorder: An international Delphi study. Addiction, 116(9), 24632475. https://doi.org/10.1111/add.15411.

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  • Flayelle, M. , Schimmenti, A. , Starcevic, V. , & Billieux, J. (2022). The pitfalls of recycling substance-use disorder criteria to diagnose behavioral addictions. In Heather, N. , Field, M. , Moss, A. C. , & Satel, S. (Eds.), Evaluating the brain disease model of addiction (pp. 339349). London, UK: Routledge. https://doi.org/10.4324/9781003032762-34.

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  • Jablensky, A. (2016). Psychiatric classifications: Validity and utility. World Psychiatry, 15(1), 2631. https://doi.org/10.1002/wps.20284.

  • Kaptsis, D. , King, D. L. , Delfabbro, P. , & Gradisar, M. (2016). Withdrawal symptoms in internet gaming disorder: A systematic review. Clinical Psychology Review, 43, 5866. https://doi.org/10.1016/j.cpr.2015.11.006.

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  • King, D. L. , Herd, M. C. E. , & Delfabbro, P. (2017). Tolerance in internet gaming disorder: A need for increasing gaming time or something else? Journal of Behavioral Addictions, 6(4), 525533. https://doi.org/10.1556/2006.6.2017.072.

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  • Kluwe-Schiavon, B. , Viola, T. W. , Sanvicente-Vieira, B. , Lumertz, F. S. , Salum, G. A. , Grassi-Oliveira, R. , & Quednow, B. B. (2020). Substance related disorders are associated with impaired valuation of delayed gratification and feedback processing: A multilevel meta-analysis and meta-regression. Neuroscience and Biobehavioral Reviews, 108, 295307. https://doi.org/10.1016/j.neubiorev.2019.11.016.

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  • Knight, R. A. , & Du, R. (2021). The structure, covariates, and etiology of hypersexuality: Implications for sexual offending. Current Psychiatry Reports, 23(50), 111. https://doi.org/https://doi.org/10.1007/s11920-021-01260-w.

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  • Koós, M. , Fuss, J. , Klein, V. , Demetrovics, Z. , & Bőthe, B. (2021). Sexual motivations underlying compulsive sexual behavior in women and men from Germany and Hungary. The Journal of Sexual Medicine, 112. https://doi.org/10.1016/j.jsxm.2021.11.005.

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  • Kor, A. , Fogel, Y. , Reid, R. C. , & Potenza, M. N. (2013). Should hypersexual disorder be classified as an addiction? Sexual Addiction & Compulsivity, 20(1–2). https://doi.org/10.1080/10720162.2013.768132.

    • Search Google Scholar
    • Export Citation
  • Kowalewska, E. , Grubbs, J. B. , Potenza, M. N. , Gola, M. , Draps, M. , & Kraus, S. W. (2018). Neurocognitive mechanisms in compulsive sexual behavior disorder. Current Sexual Health Reports, 10, 255264. https://doi.org/10.1007/s11930-018-0176-z.

    • Search Google Scholar
    • Export Citation
  • Kraus, S. W. , Krueger, R. B. , Briken, P. , First, M. B. , Stein, D. J. , Kaplan, M. S. , … Reed, G. M. (2018). Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry, 17(1), 109110. https://doi.org/10.1002/wps.20499.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kraus, S. W. , Sturgeon, J. A. , & Potenza, M. N. (2018). Specific forms of passionate attachment differentially mediate relationships between pornography use and sexual compulsivity in young adult men. Sexual Addiction and Compulsivity, 25(4), 380395. https://doi.org/10.1080/10720162.2018.1532362.

    • Search Google Scholar
    • Export Citation
  • Kraus, S. W. , Voon, V. , & Potenza, M. N. (2016). Should compulsive sexual behavior be considered an addiction? Addiction, 111(12), 20972106. https://doi.org/10.1111/add.13297.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O’Doherty, J. P. , Cockburn, J. , & Pauli, W. M. (2017). Learning, reward, and decision making. Annual Review of Psychology, 68, 73. https://doi.org/10.1146/ANNUREV-PSYCH-010416-044216.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Orford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal of Addiction, 73(3), 299310. https://doi.org/10.1111/j.1360-0443.1978.tb00157.x.

    • Search Google Scholar
    • Export Citation
  • Over, R. , & Koukounas, E. (1995). Habituation of sexual arousal: Product and process. Annual Review of Sex Research, 6(1), 187223. https://doi.org/10.1080/10532528.1995.10559905.

    • Search Google Scholar
    • Export Citation
  • Perales, J. C. , King, D. L. , Navas, J. F. , Schimmenti, A. , Sescousse, G. , Starcevic, V. , … Billieux, J. (2020). Learning to lose control: A process-based account of behavioral addiction. Neuroscience and Biobehavioral Reviews, 108, 771780. https://doi.org/10.1016/j.neubiorev.2019.12.025.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Potenza, M. N. , Gola, M. , Voon, V. , Kor, A. , & Kraus, S. W. (2017). Is excessive sexual behaviour an addictive disorder? The Lancet Psychiatry, 4(9), 663664. https://doi.org/10.1016/S2215-0366(17)30316-4.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Reid, R. C. , & Kafka, M. P. (2014). Controversies about hypersexual disorder and the DSM-5. Current Sexual Health Reports, 6(4), 259264. https://doi.org/10.1007/s11930-014-0031-9.

    • Search Google Scholar
    • Export Citation
  • Robinson, T. E. , & Berridge, K. C. (2001). Incentive-sensitization and addiction. Addiction, 96(1), 103114. https://doi.org/10.1046/j.1360-0443.2001.9611038.x.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Sassover, E. , & Weinstein, A. (2022). Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view. Journal of Behavioral Addictions, 11(2), 166179. https://doi.org/10.1556/2006.2020.00055.

    • Search Google Scholar
    • Export Citation
  • Starcevic, V. (2016). Tolerance and withdrawal symptoms may not be helpful to enhance understanding of behavioural addictions. Addiction, 111(7), 13071308. https://doi.org/10.1111/add.13381.

    • Search Google Scholar
    • Export Citation
  • Starcevic, V. , Billieux, J. , & Schimmenti, A. (2018). Selfitis, selfie addiction, Twitteritis: Irresistible appeal of medical terminology for problematic behaviours in the digital age. Australian and New Zealand Journal of Psychiatry, 52(5), 408409. https://doi.org/10.1177/0004867418763532.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Stark, R. , Klucken, T. , Potenza, M. N. , Brand, M. , & Strahler, J. (2018). A current understanding of the behavioral neuroscience of compulsive sexual behavior disorder and problematic pornography use. Current Behavioral Neuroscience Reports, 5(4), 218231. https://doi.org/10.1007/s40473-018-0162-9.

    • Search Google Scholar
    • Export Citation
  • Walton, M. T. , Cantor, J. M. , Bhullar, N. , & Lykins, A. D. (2017). Hypersexuality: A critical review and introduction to the “Sexhavior cycle”. Archives of Sexual Behavior, 46, 22312251. https://doi.org/10.1007/s10508-017-0991-8.

    • Search Google Scholar
    • Export Citation
  • Wegmann, E. , & Brand, M. (2020). Cognitive correlates in gaming disorder and social networks use disorder: A comparison. Current Addiction Reports, 7(3), 356364. https://doi.org/10.1007/s40429-020-00314-y.

    • Search Google Scholar
    • Export Citation
  • Werner, M. , Štulhofer, A. , Waldorp, L. , & Jurin, T. (2018). A network approach to hypersexuality: Insights and clinical implications. Journal of Sexual Medicine, 15(3), 410415. https://doi.org/10.1016/j.jsxm.2018.01.009.

    • Search Google Scholar
    • Export Citation
  • Yip, S. W. , Worhunsky, P. D. , Xu, J. , Morie, K. P. , Constable, R. T. , Malison, R. T. , … Potenza, M. N. (2018). Gray-matter relationships to diagnostic and transdiagnostic features of drug and behavioral addictions. Addiction Biology, 23(1), 394402. https://doi.org/10.1111/ADB.12492.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Yücel, M. , Oldenhof, E. , Ahmed, S. H. , Belin, D. , Billieux, J. , Bowden-Jones, H. , … Verdejo-Garcia, A. (2019). A transdiagnostic dimensional approach towards a neuropsychological assessment for addiction: An international Delphi consensus study. Addiction, 114(6), 10951109. https://doi.org/10.1111/add.14424.

    • PubMed
    • Search Google Scholar
    • Export Citation
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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

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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 850 EUR/article
Printed Color Illustrations 40 EUR (or 10 000 HUF) + VAT / piece
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
World Bank Low-income economies: 100%
Further Discounts Editorial Board / Advisory Board members: 50%
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

  • Joel BILLIEUX (University of Lausanne, Switzerland)
  • Beáta BŐTHE (University of Montreal, Canada)
  • Matthias BRAND (University of Duisburg-Essen, Germany)
  • Luke CLARK (University of British Columbia, Canada)
  • Daniel KING (Flinders University, Australia)
  • Ludwig KRAUS (IFT Institute for Therapy Research, Germany)
  • H. N. Alexander LOGEMANN (ELTE Eötvös Loránd University, Hungary)
  • Astrid MÜLLER (Hannover Medical School, Germany)
  • Marc N. POTENZA (Yale University, USA)
  • Hans-Jurgen RUMPF (University of Lübeck, Germany)
  • Attila SZABÓ (ELTE Eötvös Loránd University, Hungary)
  • Róbert URBÁN (ELTE Eötvös Loránd University, Hungary)
  • Aviv M. WEINSTEIN (Ariel University, Israel)

Editorial Board

  • Max W. ABBOTT (Auckland University of Technology, New Zealand)
  • Elias N. ABOUJAOUDE (Stanford University School of Medicine, USA)
  • Hojjat ADELI (Ohio State University, USA)
  • Alex BALDACCHINO (University of Dundee, United Kingdom)
  • Alex BLASZCZYNSKI (University of Sidney, Australia)
  • Judit BALÁZS (ELTE Eötvös Loránd University, Hungary)
  • Kenneth BLUM (University of Florida, USA)
  • Henrietta BOWDEN-JONES (Imperial College, United Kingdom)
  • Wim VAN DEN BRINK (University of Amsterdam, The Netherlands)
  • Gerhard BÜHRINGER (Technische Universität Dresden, Germany)
  • Sam-Wook CHOI (Eulji University, Republic of Korea)
  • Damiaan DENYS (University of Amsterdam, The Netherlands)
  • Jeffrey L. DEREVENSKY (McGill University, Canada)
  • Naomi FINEBERG (University of Hertfordshire, United Kingdom)
  • Marie GRALL-BRONNEC (University Hospital of Nantes, France)
  • Jon E. GRANT (University of Minnesota, USA)
  • Mark GRIFFITHS (Nottingham Trent University, United Kingdom)
  • Anneke GOUDRIAAN (University of Amsterdam, The Netherlands)
  • Heather HAUSENBLAS (Jacksonville University, USA)
  • Tobias HAYER (University of Bremen, Germany)
  • 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)
  • Jaeseung JEONG (Korea Advanced Institute of Science and Technology, Republic of Korea)
  • Yasser KHAZAAL (Geneva University Hospital, Switzerland)
  • Orsolya KIRÁLY (Eötvös Loránd University, Hungary)
  • Emmanuel KUNTSCHE (La Trobe University, Australia)
  • Hae Kook LEE (The Catholic University of Korea, Republic of Korea)
  • Michel LEJOXEUX (Paris University, France)
  • Anikó MARÁZ (Humboldt-Universität zu Berlin, Germany)
  • Giovanni MARTINOTTI (‘Gabriele d’Annunzio’ University of Chieti-Pescara, Italy)
  • Frederick GERARD MOELLER (University of Texas, USA)
  • Daniel Thor OLASON (University of Iceland, Iceland)
  • Nancy PETRY (University of Connecticut, USA)
  • Bettina PIKÓ (University of Szeged, Hungary)
  • Afarin RAHIMI-MOVAGHAR (Teheran University of Medical Sciences, Iran)
  • József RÁCZ (Hungarian Academy of Sciences, Hungary)
  • Rory C. REID (University of California Los Angeles, USA)
  • 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)
  • Ferenc TÚRY (Semmelweis University, Hungary)
  • Alfred UHL (Austrian Federal Health Institute, Austria)
  • Johan VANDERLINDEN (University Psychiatric Center K.U.Leuven, Belgium)
  • Alexander E. VOISKOUNSKY (Moscow State University, Russia)
  • Kimberly YOUNG (Center for Internet Addiction, USA)

 

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