Behavioral addictions and the associated mental health issues and psychopathology

Abstract

Introduction

Behavioral addictions are conceptually controversial and their relationship with mental health problems and psychopathology is poorly understood.

Objectives

To review the relationships between personality traits, mental health issues and mental disorders on one hand and several behavioral addictions on the other. The latter include problematic Internet use, Internet gaming disorder, hypersexual disorder/compulsive sexual behavior disorder, compulsive buying and exercise addiction.

Methods

Literature review and conceptual synthesis.

Results

Mental health issues, personality dimensions and mental disorders are commonly associated with behavioral addictions. Although some relatively specific associations were found (e.g., between Internet gaming disorder and attention deficit/hyperactivity disorder, between compulsive buying and pathological hoarding and between exercise addiction and eating disorders), the specificity of most associations was low. Most studies were cross-sectional and the direction of causality, if any, was uncertain. Therefore, it is unknown under what circumstances certain mental health issues predispose to the particular behavioral addiction or represent a primary problem and when they are a consequence of behavioral addictions. This review also underscores the importance of distinguishing between certain behavioral addictions and overlapping conditions, e.g., between compulsive buying and bipolar disorder (mania/hypomania).

Conclusions

These findings suggest that proper conceptualization of behavioral addictions as distinct conditions or a manifestation of an underlying psychopathology will have to await results of the prospective studies. In the meantime, there are implications for treatment in terms of the importance of identifying and addressing the underlying or associated mental health problems in individuals with behavioral addictions.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.