Behavioral addictions: Past, present and future.

Behavioral addictions are a specific group of mental and behavioral disorders. At present, this group of disorders is not present in DSM-IV (American Psychiatric Association, 2000) or ICD-10 (World Health Organization, 1994). However, in spite of this, the Substance-related disorders group of the DSM-IV has proposed revisions to this that opens up the possibility for non-substance disorders to be subsumed under the name Substance Use and Addictive Disorders. This is because one non-chemical addiction (i.e., pathological gambling) has become part of this group (Holden, 2010). Other disorders currently treated as behavioral addictions elsewhere in the academic literature (e.g., video game addiction, sex addiction, exercise addiction) look as though they may take some time to be included in recognized psychiatric diagnostic manuals. These excessive disorders that do not typically involve the ingestion of a psychoactive substance – and are typically identified as behavioral addictions (Griffiths, 1996) – do not form an independent group or belong to the same group as chemical addictions to date. However, there are two points in the forthcoming DSM-V where these disorders potentially overlap. One is in the section on Obsessive-Compulsive and Related Disorders, which assembles the disorders predominantly characterized by risk avoidance and is located on the compulsive end of the obsessive-compulsive spectrum (Hollander, 1993). Alternatively, the second intersection, where the disorders that can be identified on the impulsive end of the spectrum and which are accordingly characterized by risk seeking behavior, is included as Disruptive, Impulse Control and Conduct Disorders in DSM-V. At present, this is the state of contemporary thinking concerning behavioral addictions being treated as one group of disorders. Although the concept of behavioral addiction appears to be on the increase in terms of usage in the literature, as yet (with the exception of pathological gambling), there is not enough empirical evidence to treat these disorders as parts of one comprehensive and homogenous group. These disorders (such as pathological gambling behavior, problematic internet use, problematic use of computer and video games, problematic online gaming, problematic social networking, pyromania, kleptomania, intermittent explosive disorder, trichotillomania, onychophagia, skin picking disorder, compulsive buying, hypersexual disorders, compulsive hoarding, exercise addiction, obsessive-compulsive disorder, various types of eating disorder, body dysmorphic disorder, muscle dysmorphic disorder, hypochondriasis, attention deficit and hyperactivity disorder, etc.) comprise a highly heterogeneous group. Furthermore, although many of these behaviors share similar characteristics in common both with each other, and with substance use disorders (Grant, Potenza, Weinstein & Gorelick, 2010), there are also significant differences. In many of these disorders, there is still limited scientific and empirical support as to their inclusion as a behavioral addiction. Furthermore, there are many deficiencies in the exploration of their symptomatology, validation measures, and – at present – there are very few studies regarding the epidemiology and etiology of these disorders. In the past two decades, a few such concepts have emerged that have helped (or might help) in conceptually integrating these disorders. These may include the already mentioned obsessive-compulsive spectrum disorders approach of Hollander (1993), or may include different perspectives, such as the reward deficiency syndrome hypothesis (Blum et al., 2000), or the addiction components model of Griffiths (2005). All of these approaches attempt an integrative synthesis and attempt help to deal with these disorders within a comprehensive theoretical framework, independent of the name that is applied to such behaviors. Given these theoretical and empirical studies, approaches and concerns, the main aim of the Journal of Behavioral Addictions is therefore to provide an interdisciplinary forum for the scientific discussion concerning these disorders that belong to the overarching concept of behavioral addictions. On one hand, the journal aims to explore the unique and specific characteristics of these phenomena, while on the other hand it aims to assist the empirical and conceptual analysis of the behavioral addiction debate. Such studies will provide insight and clarity regarding the relationship between these many different disorders. A further field of enquiry might include the analysis of the addictive characteristics of disorders not traditionally considered as bona fide addictive disorders or the further exploration of the relationships between substance-related and non-substance related addictive disorders. Given this wide remit, we are looking forward to receiving manuscripts on these and other issues related to all aspects of behavioral addiction.