Epidemiological Challenges in the Study of Behavioral Addictions: a Call for High Standard Methodologies

in Current Addiction Reports (2019), 6(3), 331-337

Purpose of Review The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes gambling disorder in the section on substance-related and addictive disorders, and the ... [more ▼]

Purpose of Review The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes gambling disorder in the section on substance-related and addictive disorders, and the 11th revision of the International Classification of Diseases (ICD-11) includes both gambling and gaming disorder as disorders due to addictive behaviors. However, there is less evidence for other putative behavioral addictions. This review focuses on requirements for epidemiological studies of disorders that may be considered as behavioral addictions and compares the current state of research with principles of sound epidemiological research. Recent Findings In studies of behavioral addictions, samples are often quite small, which may lead to increased random error. The lack of sound assessment tools—particularly the lack of agreed-upon diagnostic criteria and standardized diagnostic interviews—may also increase systematic error. Other concerns related to systematic bias include the use of convenience samples, lack of pro-active recruitment, inadequate assessment of confounding variables, and a dearth of representative and longitudinal studies. Summary This review recommends that future studies of putative behavioral addictions should more closely adhere to methodological standards of epidemiological research to reduce random and systematic error. Specific recommendations are detailed to advance epidemiological research in this area with the aim of improving the evidence base and generating more refined public health recommendations and policies. [less ▲]

Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective.

in Journal of behavioral addictions (2018), 7(3), 556-561

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate ... [more ▼]

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it. [less ▲]