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Gambling Disorder and Other Behavioral Addictions: Recognition and Treatment
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Addiction professionals and the public are recognizing that certain nonsubstance behaviors--such as gambling, Internet use, video-game playing, sex, eating, and shopping--bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions and has led to the newly introduced diagnostic category "Substance-Related and Addictive Disorders" in DSM-5. At present, only gambling disorder has been placed in this category, with insufficient data for other proposed behavioral addictions to justify their inclusion. This review summarizes recent advances in our understanding of behavioral addictions, describes treatment considerations, and addresses future directions. Current evidence points to overlaps between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts. Differences also exist. Recognizing behavioral addictions and developing appropriate diagnostic criteria are important in order to increase awareness of these disorders and to further prevention and treatment strategies.
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“Both pharmacological and psychological treatments have been suggested, similar to what is recommended for gambling disorder and other behavioral addictions (e.g., Grant et al., 2013;Yau and Potenza, 2015), and initial studies suggest varying degrees of efficacy (Cash et al., 2012;Santos et al., 2016;Winkler et al., 2013;Young, 2013).”
From Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model (2016) · cites this paper as Yau and Potenza, 2015
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“…and ‘gambling disorder’ has now been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).7 Gambling disorder can be described as persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress (Yau and Potenza 2015).”
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“This is particularly the case in problem gambling research — the longest established domain of research related to behavioral addiction (Yau & Potenza, 2015).”
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“53 On the other hand, the recognition of technology addiction emerged in the mid-1990s, marking a new type of societal concern, particularly as the media began to focus more on the concept of computer or internet addiction.”
BackgroundEmotional regulation in gambling disorder
Mestre‐Bach, G., Fernández‐Aranda, F., Jiménez‐Múrcia, S., & Potenza, M. N. (2020) · Current Opinion in Behavioral Sciences · doi:10.1016/j.cobeha.2020.03.004 · Cited by 18
Self-citationThe prevalence and features of schizophrenia among individuals with gambling disorder
Granero, R., Fernández‐Aranda, F., del Pino‐Gutiérrez, A., Etxandi, M., Baenas, I., Gómez‐Peña, M., Moragas, L., Valenciano‐Mendoza, E., Mora‐Maltas, B., Valero-Solís, S., et al. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.02.025 · Cited by 18
Claesdotter‐Knutsson, E., André, F., Fridh, M., Delfin, C., Håkansson, A., & Lindström, M. (2022) · JMIR Pediatrics and Parenting · doi:10.2196/35207 · Cited by 17
“Although gambling disorder is traditionally considered an adult phenomenon, the behavior usually begins in childhood or adolescence and more frequently in younger ages among males, in resemblance with both substance use disorders and pathological gaming [2].”
BackgroundInfluentialGrassi, G., Moradei, C., & Cecchelli, C. (2024) · Journal of Behavioral Addictions · doi:10.1556/2006.2024.00020 · Cited by 17
“Indeed, reward processing dysfunctions, response inhibition deficits and executive function deficits have been largely documented both in subjects with ADHD and behavioral addictions (Yau et al., 2015).”
BackgroundDisrupting Unwanted Habits in Online Gambling Through Information Technology
Hou, J., Kim, K., Kim, S. S., & Ma, X. (2019) · Journal of Management Information Systems · doi:10.1080/07421222.2019.1661088 · Cited by 19
“difficult to change habit all by themselves and had to explicitly seek external help from the operator [51, 95].”
BackgroundExploration of Intervention Strategies to Reduce Public Stigma Associated with Gambling Disorder
Brown, K. L., & Russell, A. M. T. (2019) · Journal of Gambling Studies · doi:10.1007/s10899-019-09888-3 · Cited by 17
Genetic Addiction Risk and Psychological Profiling Analyses for “Preaddiction” Severity Index
Blum, K., Han, D. C., Bowirrat, A., Downs, B. W., Bagchi, D., Thanos, P. K., Baron, D. A., Braverman, E. R., Dennen, C. A., Gupta, A., et al. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12111772 · Cited by 19
Smartphone Apps for Problem Gambling: a Review of Content and Quality
McCurdy, L. Y., Loya, J. M., Hart-Derrick, V. R., Young, G. C., Kiluk, B. D., & Potenza, M. N. (2023) · Current Addiction Reports · doi:10.1007/s40429-023-00479-2 · Cited by 15
Self-citationWilliams, B. D., Lee, K., Ewah, S. O., & Neelam, K. (2023) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001773 · Cited by 16
Castro‐Calvo, J., Ballester‐Arnal, R., Gil‐Llario, M. D., & Giménez‐García, C. (2016) · Computers in Human Behavior · doi:10.1016/j.chb.2016.05.066 · Cited by 16
“In this regard, Yau and Potenza (2015) suggested that “the two sets of disorders may represent different expressions of one addiction entity (pp. 135)”.”
BackgroundMaremmani, A. G. I., Gazzarrini, D., Fiorin, A., Cingano, V., Bellio, G., Perugi, G., & Maremmani, I. (2018) · Annals of General Psychiatry · doi:10.1186/s12991-018-0173-7 · Cited by 16
“craving, tolerance, withdrawal symptoms), comorbidity, neurobiological profile, heritability, and treatment [2].”
Emotional 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
Predictors of adverse gambling behaviours amongst elite athletes
Turk, M., Murphy, C., McCaffrey, J., & Murray, K. (2023) · Scientific Reports · doi:10.1038/s41598-023-27469-8 · Cited by 15
Maladaptive consequences of repeated intermittent exposure to uncertainty
Mascia, P., Wang, Q., Brown, J., Nesbitt, K. M., Kennedy, R. T., & Vezina, P. (2020) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.109864 · Cited by 14
A Systematic Review of Eye-Tracking Studies of Gambling-Related Attentional Biases
Takahashi, R. E. S., Kim, H. S. A., Coelho, S. G., & Tavares, H. (2022) · Journal of Gambling Studies · doi:10.1007/s10899-022-10161-3 · Cited by 14
“…Psychiatric Association, 2013), in which it is now classified under Substance-Related and Addictive Disorders due to its similarities to substance use disorders in clinical presentation and etiology (e.g., personality and neurobiological risk factors; Yau and Potenza, 2015; Vitaro et al., 2014).”
BackgroundService Development for Behavioural Addictions: AIIMS Experience
Balhara, Y. P. S., Bhargava, R., & Chadda, R. K. (2020) · Annals of the National Academy of Medical Sciences (India) · doi:10.1055/s-0040-1712755 · Cited by 14
“The proportion of persons with pathological gambling is relatively higher among college students (3).”
BackgroundDopamine and Gambling Disorder: Prospects for Personalized Treatment
Kayser, A. S. (2019) · Current Addiction Reports · doi:10.1007/s40429-019-00240-8 · Cited by 16
Hofstedt, A., Mide, M., Arvidson, E., Ljung, S., Lindskog, A., Mattiasson, J., & Gordh, A. S. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1162492 · Cited by 14
Bellmunt‐Gil, A., Majuri, J., Arponen, E., Kaasinen, V., & Joutsa, J. (2023) · Journal of Behavioral Addictions · doi:10.1556/2006.2023.00037 · Cited by 15
Makas, S., & Koç, M. (2025) · Scientific Reports · doi:10.1038/s41598-024-84482-1 · Cited by 13
Scandroglio, F., Ferrazzi, G., Giacobazzi, A., Vinci, V., Marchi, M., Galeazzi, G., Musetti, A., & Pingani, L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010452 · Cited by 10
“When examining epidemiological studies, we should consider that research conducted with screening instruments have frequently shown a higher prevalence of this disorder, compared with studies which used the DSM criteria [29].”
BackgroundResultLarsen, J. K., Hollands, G. J., Garland, E. L., Evers, A. W. M., & Wiers, R. W. H. J. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105408 · Cited by 12
Sherer, J., & Levounis, P. (2022) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2022.04.007 · Cited by 13
King, S. M., & Whelan, J. P. (2020) · Issues in Mental Health Nursing · doi:10.1080/01612840.2020.1804019 · Cited by 12
Bellino, S., Bozzatello, P., Badino, C., Mantelli, E., & Rocca, P. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22020620 · Cited by 12
“Moreover, gambling, as well as drugs or alcohol, stimulates the reward system of the brain, which is responsible for the addiction behaviours [75].”
BackgroundDias, P. C. A., Cadime, I., del Castillo-López, Á. G., García-Castillo, F., & del Castillo, J. A. G. (2018) · African journal of rhetoric · doi:10.21134/haaj.v18i1.377 · Cited by 12
Worsened Anxiety and Loneliness Influenced Gaming and Gambling during the COVID-19 Pandemic
Mohamed, M. S., Rukh, G., Schiöth, H. B., Vadlin, S., Olofsdotter, S., Åslund, C., & Nilsson, K. W. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm12010249 · Cited by 12
“Internet gaming disorder (IGD) was introduced in Section three, “Conditions for further studies”, in the DSM-5 [4].”
BackgroundInfluentialDubuson, M., Noël, X., Kornreich, C., Hanak, C., Saeremans, M., & Campanella, S. (2023) · Biology · doi:10.3390/biology12050643 · Cited by 15
“Indeed, clear overlaps exist between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts, but differences also exist [50].”
BackgroundMeta-analysis of structural and functional abnormalities in behavioral addictions
Mei, B., Tao, Q., Dang, J., Niu, X., Sun, J., Zhang, M., Wang, W., Zhang, Y., Zhang, Y., & Cheng, J. (2024) · Addictive Behaviors · doi:10.1016/j.addbeh.2024.108088 · Cited by 12
Are Malaysian Youths Overdependent on the Internet?: A Narrative Review
Jaafar, N. R. N., Bahar, N., Ibrahim, N., Baharudin, A., Ismail, W. S. W., Sim, S. T., Aziz, M. A., & Tan, K. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.710790 · Cited by 11
Correlates of sedentary behavior in Asian preschool‐aged children: A systematic review
Chen, B., Kui, K. Y., Padmapriya, N., Müller, A. M., & Müller‐Riemenschneider, F. (2022) · Obesity Reviews · doi:10.1111/obr.13485 · Cited by 11
“This is plausible as older children may have greater access to mobile devices and are less controlled by their parents.(53) Biological sex was not consistently associated with total SB or SV, a finding aligned with a previous review.”
Mastropietro, S., Favieri, F., Forte, G., Locuratolo, N., Mannarelli, D., Pauletti, C., Fattapposta, F., & Casagrande, M. (2022) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-022-00906-x · Cited by 13
“…characterized by alteration in similar brain areas (i.e., dorsolateral, orbital, and ventral medial prefrontal cortex; striatum; mesocorticolimbic system; see Brand et al., 2014; Dong et al., 2011; Gearhardt et al., 2011; Ko et al., 2009; Long et al., 2018; Yau & Potenza, 2015; Power et al., 2012).”
Income Inequality and the Odds of Online Gambling Among a Large Sample of Adolescents in Canada
Pabayo, R., Patel, P., Patte, K. A., & Leatherdale, S. T. (2023) · Journal of Gambling Studies · doi:10.1007/s10899-023-10194-2 · Cited by 11
“…gambling may lead to more severe consequences, including the development of gambling problems, and is often defined by experiencing one or two negative effects of gambling (Yau & Potenza, 2015), such as higher levels of distress and alcohol dependence, and family problems (Marshall & Wynne, 2004).”
Genetic Correlates as a Predictor of Bariatric Surgery Outcomes after 1 Year
Thanos, P. K., Hanna, C., Mihalkovic, A., Hoffman, A. B., Posner, A. R., Butsch, J. L., Blum, K., Georger, L. A., Mastrandrea, L. D., & Quattrin, T. (2023) · Biomedicines · doi:10.3390/biomedicines11102644 · Cited by 11
“In addition to psychological screenings, an individual’s genetic makeup can be observed [40–43] to highlight a propensity towards behavioral addictions [44], giving clinicians further opportunities to tailor interventions and maximize the likelihood of the operation’s success.”
Background
Metadata
- Authors
- Yau, Y. H. C., & Potenza, M. N.
- Affiliations
- Yale University (US)
- Corresponding author
- Potenza, Marc N.
- Venue
- Harvard Review of Psychiatry
- Published
- 2015-03
- Volume
- 23
- Issue
- 2
- Pages
- 134-146
- ISSN
- 1067-3229 (ISSN-L)
- PMC
- PMC4458066
- OpenAlex
- W2096389535
- Cited by
- 267
- References
- 187
- Citations by year
- 2026: 26 · 2025: 33 · 2024: 31 · 2023: 34 · 2022: 31 · 2021: 26 · 2020: 22 · 2019: 21 · 2018: 18 · 2017: 7 · 2016: 15 · 2015: 3
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Harvard Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA018647, P50DA009241, R01DA035058, P20DA027844)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- gambling addiction, behavioral addiction, DSM-5, substance-related and addictive disorders, comorbidities, neurobiology of addiction, genetic contribution, treatment, prevention, internet addiction, sexual addiction, eating disorders, compulsive buying, gaming addiction
- MeSH terms
- Gambling, Humans, Cognitive Behavioral Therapy, Behavior, Addictive, Internet, Diagnostic and Statistical Manual of Mental Disorders
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