Behavioral Addictions: An Overview
Abstract
The legitimacy of nonsubstance addictions has received increased attention from clinicians, researchers and the general population as more and more individuals report symptoms consistent with impairment of impulse control. The clinical presentation of these disorders is varied, as compulsive activities may include: gambling, eating, sex, shopping, use of the Internet or videogames or even exercising, working or falling in love. As such, there is great controversy in diagnosing, treating or even naming these conditions, as many of these behaviors are daily rituals instrumental to our ultimate survival. Historically, the phrase "impulse control disorders" described these conditions but many researchers and clinicians also use the term "behavioral addictions," "process addictions" or "impulsive-compulsive behaviors" to report behavioral pathology. This review summarizes the data of each of these behavioral addictions from epidemiology to neurobiology to treatment options. Research suggests similarities between natural and drug reward processing but clinical evidence supports the utilization of treatment modalities for these behavioral conditions that can sometimes differ from traditional drug treatment.
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Internet addiction is now widely accepted as an addiction.
“it is now widely accepted that it is an addiction (Block, 2008; Ha, Yoo, Cho, Chin, Shin, & Kim, 2006; Karim & Chaudhri, 2012; Olsen, 2011; Robbins & Clark, 2015; Tao et al., 2010; Young, 1996, 1998b, 2004; Young & Rogers, 1998).”
From Ethics of the Attention Economy: The Problem of Social Media Addiction (2021) · cites this paper as Karim & Chaudhri, 2012
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Behavioral Addiction: The Nexus of Impulsivity and Compulsivity
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Kim, H., Kim, Y. K., Lee, J. Y., Choi, A., Kim, D., & Choi, J.-S. (2019) · Progress in Neuro-psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2019.109680 · Cited by 23 · see citing works
Video Game Addiction: what can we learn from a media neuroscience perspective?
Craighead, B., Huskey, R., & Weber, R. (2015) · Revista Argentina de Ciencias del Comportamiento · doi:10.32348/1852.4206.v7.n3.10086 · Cited by 23 · see citing works
“Since then, an abundance of evidence has implicated the dopaminergic system in the regulation of rewarding behaviors as well as behavioral addictions (Karim & Chaudhri, 2012).”
BackgroundInfluentialSubstance-related and behavioural addiction problems: Two surveys of Canadian adults
Thege, B. K., Colman, I., el-Guebaly, N., Hodgins, D., Patten, S., Schopflocher, D., Wolfe, J., & Wild, T. (2015) · Addiction Research & Theory · doi:10.3109/16066359.2014.923408 · Cited by 23 · see citing works
“Behaviours associated with this liability include gambling, excessive Internet use, shopping, working, exercising, eating, video game playing, and sexual activity (Karim & Chaudhri, 2012).”
BackgroundA Study of Digital Game Addiction from Aggression, Loneliness and Depression Perspectives
Jeong, E. J., Kim, D. J., Lee, D. M., & Lee, H. R. (2016) · Hawaii International Conference on System Sciences (HICSS) · doi:10.1109/hicss.2016.470 · Cited by 39 · see citing works
Cognitive training: A new avenue in gambling disorder management?
Luquiens, A., Miranda, R., Benyamina, A., Carré, A., & Aubin, H. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.10.011 · Cited by 22 · see citing works
Microbes Saving Lives and Reducing Suffering
Timmis, K. N., Karahan, Z. C., Ramos, J. L., Koren, O., Pérez‐Cobas, A. E., Steward, K. F., de Lorenzo, V., Caselli, E., Douglas, M., Schwab, C., et al. (2025) · Microbial Biotechnology · doi:10.1111/1751-7915.70068 · Cited by 23 · see citing works
Lee, J.-Y., Song, M., Yoo, S. Y., Jang, J., Lee, D., Jung, Y.-C., Ahn, W.-Y., & Choi, J.-S. (2024) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2024.152460 · Cited by 20 · see citing works
Paz, G., Griffiths, M. D., Demetrovics, Z., & Szabó, A. (2019) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-019-00109-x · Cited by 19 · see citing works
“Epidemiological findings have consistently found that sexual addiction and hypersexuality are more prevalent among men than women (Barrilleaux 2016; Karila et al. 2014; Karim and Chaudhri 2012; Wilcox 2015).”
BackgroundCavicchioli, M., Vassena, G., Movalli, M., & Maffei, C. (2018) · Journal of Addictive Diseases · doi:10.1080/10550887.2019.1643211 · Cited by 20 · see citing works
Clinical and Research Implications of Gambling Disorder in DSM-5
Weinstock, J., & Rash, C. J. (2014) · Current Addiction Report · doi:10.1007/s40429-014-0026-7 · Cited by 20 · see citing works
Mauer-Vakil, D., & Bahji, A. (2020) · The Canadian Journal of Addiction · doi:10.1097/cxa.0000000000000091 · Cited by 19 · see citing works
Smoking, ADHD, and Problematic Video Game Use: A Structural Modeling Approach
Lee, H. J., Tran, D. D., & Morrell, H. E. R. (2018) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2017.0429 · Cited by 22 · see citing works
“46 Studies indicate similar neurological dysfunctions in individuals with pathological gambling and individuals with substance use disorders when compared to healthy controls, such as low levels of serotonin metabolite 5-hydroxyindole acetic acid in cerebrospinal fluid, 47 and low levels of ventral…”
Elmquist, J., Shorey, R., Anderson, S., & Stuart, G. L. (2015) · Journal of Substance Use · doi:10.3109/14659891.2015.1029021 · Cited by 19 · see citing works
“There has been a growing impetus to elucidate the etiology and mechanisms of behavioral, non-substance addictions, particularly compulsive sexual behaviors (CSBs) (Karim & Chaudhri, 2012; Najavits et al., 2014).”
BackgroundEmotional Regulation in Substance-Related and Addictive Disorders Treatment: A Systematic Review
Chrétien, S., Giroux, I., Smith, I., Jacques, C., Ferland, F., Sévigny, S., & Bouchard, S. (2025) · Journal of Gambling Studies · doi:10.1007/s10899-024-10366-8 · Cited by 18 · see citing works
Dyer, A., Boehnke, J., Curran, D. B., McGrath, K., & Toner, P. (2023) · Drug and Alcohol Review · doi:10.1111/dar.13717 · Cited by 18 · see citing works
Technology and addiction: What drugs can teach us about digital media
Hartogsohn, I., & Vudka, A. (2022) · Transcultural Psychiatry · doi:10.1177/13634615221105116 · Cited by 18 · see citing works
Factores de riesgo en el uso problemático de Internet y del teléfono móvil en adolescentes españoles
Jiménez, M. D. L. V. M., & Suárez, C. (2016) · Revista Iberoamericana de Psicología y Salud · doi:10.1016/j.rips.2016.03.001 · Cited by 101 · see citing works
Nomophobia in teenagers: digital lifestyle, social networking and smartphone abuse
Ramos-Soler, I., López-Sánchez, C., & Quiles-Soler, C. (2021) · Communications Society · doi:10.15581/003.34.4.17-32 · Cited by 16 · see citing works
“…are not identified or defined given the difficulty to differentiate between normal and pathological behaviors (Echeburúa, Labrador & Becoña, 2009; Karim & Chaudhri, 2012; García del Castillo, 2013; Machimbarrena, González-Cabrera, Ortega-Barón, Beranuy-Fargues, Álvarez-Bardón & Tejero, 2019).”
BackgroundBinge Eating and Addictive-Like Behaviours in Males and Females
Levallius, J., Monell, E., Birgegård, A., Clinton, D., & Mantilla, E. F. (2020) · Psychological Reports · doi:10.1177/0033294120971750 · Cited by 16 · see citing works
“Key symptoms of eating disorder actually show similar patterns of development (Davis, 2013; Godier & Park, 2014, 2015; Karim & Chaudhri, 2012; Lloyd et al., 2017; Morris & Voon, 2016; Schulte et al., 2016).”
BackgroundBibbey, A., Phillips, A. C., Ginty, A. T., & Carroll, D. (2015) · Journal of Behavioral Addictions · doi:10.1556/2006.4.2015.006 · Cited by 32 · see citing works
“…responses especially given that these constructs are proposed to incorporate more pathological (Bamber, Cockerill & Carroll, 2000; Berczik et al., 2012; Egorov & Szabo, 2013; Karim & Chaudhri, 2012) and are likely to persist into adulthood (Allen, Byrne, Oddy & Crosby, 2013; Berczik et al., 2012).”
BackgroundLambert, L. T. K. (2013) · Journal of addiction medicine · doi:10.1097/adm.0b013e318284dac8 · Cited by 15
Shen, M. K., Huang, J., Liang, O., Kim, I.-J., & Yoon, D. (2026) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3772318.3790896 · Cited by 7 · see citing works
“Addictive behaviours often begin with intentional, directed, or casual use, but can escalate into compulsive, dependent patterns through repeated reinforcement of reward pathways [58, 60].”
Addiction chronicity: are all addictions the same?
Gooding, N. B., Williams, J. N., & Williams, R. J. (2022) · Addiction Research & Theory · doi:10.1080/16066359.2022.2035370 · Cited by 15 · see citing works
“Substance use disorder, gambling disorder, and other excessive behaviors share much in common in terms of their epidemiology and neurobiology (Marlatt et al. 1988; Shaffer et al. 2004; Grant et al. 2006; Karim and Chaudhri 2012; MacKillop and Ray 2018; Sussman et al. 2017).”
BackgroundSocial relational factors of excessive internet use in four European countries
Mikuška, J., Šmahel, D., Dědková, L., Staksrud, E., Mascheroni, G., & Milošević, T. (2020) · International Journal of Public Health · doi:10.1007/s00038-020-01484-2 · Cited by 16 · see citing works
Analyzing Motivational Determinants of Shopping Addiction Tendency
Kirazli, Ö., & Arslan, F. (2019) · Ege Academic Review · doi:10.21121/eab.2019148775 · Cited by 14
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Sexual addiction: A literature review of treatment interventions
Miles, L. A., Cooper, R., Nugent, W., & Ellis, R. A. (2016) · Journal of Human Behavior in the Social Environment · doi:10.1080/10911359.2015.1062672 · Cited by 14 · see citing works
“The pleasure created from the neuro response system subsequently acts as a positive reinforcement for the sexual behavior (Karim & Chaudhri, 2012).”
BackgroundElmquist, J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2016) · Journal of Clinical Psychology · doi:10.1002/jclp.22310 · Cited by 13 · see citing works
“In the current study, compulsive sexual behaviors will be used to refer to problematic sexual behaviors to be consistent with the terminology used in the assessment measure used for the present study and recent research (Karim & Chaudhri, 2012; Najavits et al., 2014).”
MethodGül, I., & Özgür, H. (2023) · Trakya Eğitim Dergisi · doi:10.24315/tred.1325214 · Cited by 13 · see citing works
I feel addicted to watching TV series: association between binge-watching and mental health
Favieri, F., Forte, G., Tambelli, R., Tomai, M., & Casagrande, M. (2023) · PeerJ · doi:10.7717/peerj.15796 · Cited by 12 · see citing works
McCutcheon, L., Zsila, Á., & Demetrovics, Z. (2021) · BMC Psychology · doi:10.1186/s40359-021-00679-3 · Cited by 12
“relationships and cognitive functioning [11].”
Autonomic Nervous System and Brain Circuitry for Internet Addiction
Huang, A. (2015) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-319-07242-5_7 · Cited by 12 · see citing works
Gürbüzer, N., & Gürcan-Yıldırım, D. (2025) · Humanities and Social Sciences Communications · doi:10.1057/s41599-025-04623-3 · Cited by 11 · see citing works
“Studies show that behavioral addictions can signi fi cantly reduce people ’ s quality of life (Robbins and Clark 2015), and the etiology and mechanisms behind behavioral addictions are not well understood yet (Karim and Chaudhri 2012).”
Attitude toward Selfie Taking and its Relation to Body Image and Narcissism in Medical Students
Dutta, E., Sharma, P., Shah, N., Bharati, A. S., Sonavane, S., & Desousa, A. (2018) · Indian Journal of Psychological Medicine · doi:10.4103/ijpsym.ijpsym_169_17 · Cited by 11 · see citing works
“With younger adults being a major chunk of mobile phone users, there is a high proportion of internet addiction and smartphone addiction reported in this population.([4])”
BackgroundCounselors' Understanding of Process Addiction: A Blind Spot in the Counseling Field.
Wilson, A., & Johnson, P. (2013) · The Professional Counselor · doi:10.15241/adw.3.1.16 · Cited by 11 · see citing works
“According to Karim and Chaudhri (2012), a disproportionate amount of time spent on planning for and participating in sexual activity, participating in sexual activity to alter one’s mood or as a way to handle stress, inability to control sexual compulsions and sexual fantasies, and engaging in…”
BackgroundLove Addiction, Emotional Dysregulation and Attachment Bonds: A Quantitative Study of 344 Females
Salani, A., Antonelli, P., Salvatori, G., Gritti, M. C., Bisciglia, R., Mascherini, F., & Dèttore, D. (2022) · Sexual Health & Compulsivity · doi:10.1080/26929953.2022.2110546 · Cited by 11 · see citing works
“…2010), however, suggest it should be considered as a behavioral addiction, along with other disorders such as pathological gambling, internet gaming disorder or sexual addiction (American Psychiatric Association, 2022; Ascher & Levounis, 2015; Karim & Chaudhri, 2012; Robbins & Clark, 2015).”
Background
- Authors
- Karim, R., & Chaudhri, P.
- Affiliations
- University of California, Los Angeles (US)
- University of California System (US)
- Corresponding author
- Karim, Reef
- Venue
- Journal of Psychoactive Drugs
- Publisher
- Informa UK Limited
- Published
- 2012-01
- Volume
- 44
- Issue
- 1
- Pages
- 5-17
- ISSN
- 0279-1072 (ISSN-L)
- 2159-9777
- OpenAlex
- W2088486380
- Cited by
- 239
- References
- 119
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 12 · 2023: 14 · 2022: 16 · 2021: 19 · 2020: 20 · 2019: 16 · 2018: 19 · 2017: 11 · 2016: 19 · 2015: 28 · 2014: 26 · 2013: 10 · 2012: 4
- FWCI
- 24.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychoactive Drugs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- behavioral addiction, impulse control disorders, compulsive behavior, gambling addiction, eating disorders, sexual addiction, compulsive buying, online game addiction, exercise addiction, neurobiology of addiction, reward processing
- MeSH terms
- Bulimia, Compulsive Behavior, Gambling, Humans, Sexual Behavior, Behavior, Addictive, Video Games, Internet
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