Background and aims:Physical card packs are gambling-like products offering consumers random prizes. Most contain cards of little value worth less than the purchase price of the pack itself, but a few contain rare and highly valuable cards. Previous research has found a weak positive association between physical card pack spending and problem gambling, suggesting that vulnerable consumers may experience financial harm and that these physical gambling-like products may pose addiction-like risks. Unlike traditional gambling, card packs are not an adult-only product and are widely purchased by children too. Worldwide, there is currently no dedicated card pack regulation. Notwithstanding, basic consumer law applies, requiring companies to disclose and not hide important information about the product: specifically, the odds of obtaining different prizes. Methods:We sampled 50 card packs in Hong Kong representing popular products consumers buy to assess whether they disclosed winning probabilities. Results:The vast majority (80.0%) failed to provide any probability disclosure information or relevant hyperlinks on their physical packaging. The other 20.0% that provided probability disclosures failed to give sufficient details and were, occasionally, difficult to find and misleading. No pack (0.0%) allowed the consumer to know their odds of getting every individual card. Discussion and conclusions:In the absence of gambling law and dedicated regulations, consumer law should be better enforced against gambling-like products (including physical Pokémon card packs, Labubu blind boxes, and video game loot boxes) to mandate transparency and enable consumers to make more informed purchasing decisions. The potential harms posed by novel gambling-like products should be further studied and properly regulated.
Background and Aims:Generalized anxiety disorder (GAD) is highly comorbid with substance and behavioural addictions, but little is known about the psychosocial factors that underpin these relationships. The present study examined whether coping motives mediate the relationship between GAD symptom severity and the severity of symptoms of problematic alcohol use, cannabis use, gambling, and gaming more strongly at high levels of experiential avoidance. Method:Participants (N = 1,221) were Canadian adults recruited via Prolific, a crowdsourcing platform. They completed online self-report measures assessing GAD symptom severity, substance use and addictive behaviour severity, coping motives for each substance and addictive behaviour, and experiential avoidance. Results:GAD symptom severity, substance use and addictive behaviour severity, coping motives, and experiential avoidance were positively associated in bivariate correlations (r = .08 to .77). In moderated mediation analyses, coping motives mediated the positive relationship between GAD symptom severity and both problematic alcohol use (95% BCa CI [ .002, .011]) and gambling symptom severity (95% BCa CI [ .002, .009]) at low and high levels of experiential avoidance (ps < .001), such that these effects became stronger at higher levels of experiential avoidance. No significant moderated mediation effects were observed in the cannabis and gaming models. Discussion and Conclusions:Findings suggest that coping motives and experiential avoidance may interact to increase risk for both problematic alcohol use and gambling among individuals with elevated GAD symptoms, providing some empirical support for transdiagnostic conceptualizations of addictive behaviours. Such individuals may benefit from transdiagnostic psychological interventions that target maladaptive coping and experiential avoidance.
Background and aims:Gaming disorder is recognised in ICD-11 as an addictive disorder associated with persistent gaming leading to functional impairment. While many video games include monetised features such as microtransactions and other in-game purchases, financial harms are rarely examined as a potential negative consequence. The present study examined associations between higher versus lower risk of gaming disorder and two financial outcomes: game-related overspending and financial harm. Methods:Data were from the International Gaming Study 2024, a cross-sectional survey of 1,522 adult regular gamers from Australia (n = 303), China (n = 314), Indonesia (n = 300), Netherlands (n = 303) and the United States (n = 302). Gaming disorder was screened using the Gaming Disorder Identification Test (GADIT), with participants classified into higher-risk (≥5) versus lower-risk (<5) groups. Results:In adjusted logistic models, membership in the higher-risk group was strongly associated with overspending (OR = 5.36, 95% CI: 3.31-8.69) and financial harm (OR = 7.76, 95% CI: 4.88-12.35). More specifically, among participants in the higher-risk group 80.2% reported overspending and 77.8% reported financial harm compared to 42.6 and 30.6% in the lower-risk group. Odds of financial harms were higher in China and Indonesia than in Australia, while odds in the United States and Netherlands did not differ significantly from Australia. Discussion and Conclusions:Financial harms from gaming are common and most pronounced among individuals at higher risk of gaming disorder but are not limited to this group. These findings highlight the need for greater awareness of the risk for gaming-related financial harm, alongside strengthened consumer protection measures.
Background and aims:A variety of self-regulation interventions have shown efficacy in treating Internet Gaming Disorder (IGD), but their shared and unique neurobiological mechanisms remain unclear. This study aims to identify a common, trans-therapeutic neural signature of recovery and to delineate the specific connectivity fingerprints of five different self-regulation interventions for IGD. Methods:This secondary analysis pooled resting-state fMRI data from 269 individuals with IGD who participated in one of five randomized controlled trials of self-regulation-based interventions: Approach Bias Modification (ApBM), Retrieval-Aversive Conditioning (R-AC), Progressive Aerobic Training (PAT), face-to-face Mindfulness Meditation (MM), and a Digital (online) mindfulness intervention. Participants were diagnosed with IGD according to DSM-5. Partial Least Squares (PLS) regression was used to identify a shared connectivity pattern associated with clinical improvement and similarity network fusion to define intervention-specific connectivity fingerprints. Imaging-transcriptomic analysis was further used to explore the molecular correlates. Results:All interventions were associated with significant reductions in IGD severity. PLS analysis identified a shared connectivity pattern predictive of treatment response, characterized by a rebalancing of Subcortical Network (SCN) connectivity along the sensorimotor-association axis. This shared pattern was linked to gene expression profiles related to cellular stress and neuroplasticity. Each intervention also induced a unique connectivity fingerprint, targeting distinct neural circuits. Discussion and Conclusions:Diverse self-regulation interventions for IGD converge on a shared therapeutic pathway involving the large-scale reorganization of cortico-subcortical circuits. These findings identify a robust neurobiological phenotype of recovery, offering a potential biomarker for treatment response and a target for future circuit-based therapies.
Background and aims:There is a shared culture between sports betting and drinking alcohol, yet there is a lack of studies investigating predictors of simultaneous alcohol use, and whether drinking carries increased risk of gambling-related harms among sports bettors. Methods:We examined four groups of Canadian sports bettors: (1) no alcohol use (n = 70), concurrent use (n = 429), (3) sometimes-simultaneous alcohol use (n = 211), and (4) always/almost always simultaneous alcohol use (n = 198). Participants completed measures of demographic characteristics, sports gambling-related variables, alcohol problems, gambling problems, and emotion dysregulation. Results:Any simultaneous alcohol use was associated with younger age and gender diversity compared to concurrent and no alcohol use. Bisexuality was specifically linked to always simultaneous alcohol use. Always simultaneous alcohol use was also associated with higher alcohol and gambling problems compared to sometimes simultaneously drinking alcohol, despite the sometimes-simultaneous drinking group reporting higher sports betting frequency. Simultaneous alcohol use was also associated with a greater number of bets made and more money spent. Discussion and conclusions:Findings suggest that simultaneously drinking alcohol while sports betting is linked to making more bets and spending more money on bets. Demographic and psychological determinants of simultaneous drinking were generally consistent with the rest of the literature except that the group which always simultaneously drank alcohol reported lower sports gambling frequency, but greater alcohol and gambling problems. This highlights the harms associated with always simultaneously drinking while betting and also warrants future research to better understand these behaviours.
Background and aims:Deep technologies, such as artificial intelligence, blockchain, and behavioural analytics, have emerged as promising tools to address complex social challenges. However, their integration into leisure activities, particularly online gambling, has raised concerns over the enhancement of user engagement, which might promote problem gambling behaviours. This review aimed to map how deep technologies intersect with responsible gambling regulations across jurisdictions. Methods:A qualitative scoping review was conducted to synthesise evidence from academic literature, legal and regulatory frameworks, and relevant grey literature. A comparative analysis was performed across key jurisdictions, including the European Union, the United Kingdom, Malta, and selected non-European countries. Results:The review identified very few formal legal instruments that explicitly regulate the use of deep technologies in responsible gambling. The European Union Artificial Intelligence Act introduces binding requirements for high-risk AI systems, including those deployed in gambling, representing a pioneering step toward technology-specific regulation. In contrast, regulatory frameworks beyond Europe were generally non-binding or largely absent, with innovation primarily driven by operators acting voluntarily in the absence of legal mandates. Discussion and conclusions:This analysis underscores persistent gaps in legal oversight and advocates for a shift toward proactive, ethics-based governance models that integrate technological accountability and robust consumer protections. Overall, the findings suggest that regulatory frameworks must not only keep pace with rapid technological innovation but also prioritise prevention through enforceable, transparent, and harmonised policies across jurisdictions.
Background and aims:Digitalisation and rapid technological advancements have intensified socio-cultural pressures surrounding body ideals and performance, contributing to the increased use of Image and Performance Enhancing Drugs (IPED). Body dissatisfaction, muscularity-oriented concerns, and distorted self-perception represent key drivers of this phenomenon and are further amplified by digital media, which increasingly promote IPED use. Although IPED use has been consistently associated with body image disturbances and eating-related psychopathology, its relationship with behavioural addictions remains largely underexplored. This represents a critical knowledge gap, given that IPEDs are often used to shape the body, regulate mood, sustain productivity, sharpen cognition, and intensify sexual experiences, all of which may contribute to compulsive patterns of behaviour. Methods:This narrative review synthesises existing literature examining IPED use in relation to behavioural addictions, including exercise addiction, eating disorders, work addiction, gaming disorder, gambling disorder, and compulsive sexual behaviour disorder. Results:Moving beyond traditional doping frameworks, it examines how IPED use is shaped by appearance-related disorders, compulsive behaviours, and social validation pressures. Particular attention is given to the role of digital environments and online fora in facilitating access to IPEDs, normalising their use, and interacting with reinforcement processes in these conditions. By integrating previously fragmented lines of research, the review proposes a novel framework that conceptualises IPED use as recurring across diverse behavioural addictions rather than an isolated phenomenon confined to sport. Discussion and conclusions:Understanding the mechanisms linking IPED use, behavioural addictions, and digital contexts is crucial for informing targeted public health strategies and the development of effective prevention and intervention approaches.
The nomenclature used to describe harmful behavior in gaming remains vague and inconsistently applied. "Toxicity" has become the dominant label, yet it functions as an umbrella term encompassing heterogeneous behaviors that differ by context, intent, and cultural norms. This conceptual ambiguity obscures underlying psychological mechanisms that are critical for designing effective interventions. This article looks beyond descriptors to focus on psychological dynamics and how they can inform effective prevention efforts. We conducted a conceptual analysis integrating mimetic theory with existing literature on competitive gaming environments, online aggression, and community governance. We evaluated how gaming rivalry, internal group conflict, and scapegoating processes manifest in digital play and contribute to toxic behavior. Mimetic theory highlights how competitive structures can intensify interpersonal rivalry, foster cycles of retaliation, and create conditions in which players direct hostility toward convenient targets. These dynamics help explain why toxicity often escalates rapidly and becomes normalized within gaming communities. Evidence suggests that reducing competitive pressures through game design changes and strengthening community standards can mitigate these patterns. However, structural factors-such as platform incentives and limited oversight-may constrain the effectiveness of voluntary measures. Toxicity emerges from psychological, cultural, and economic forces that interact within competitive digital environments. This perspective underscores the limitations of purely taxonomic approaches and highlights the need for systemic interventions. Efforts to reduce toxicity in gaming require a comprehensive strategy that integrates psychological insight, cultural context, platform economics, and proactive governance. Mimetic theory offers a useful framework for guiding such multifaceted approaches and for informing future research on harmful online behavior.
Background and aims:Problematic smartphone use (PSU) features remain debated. This study aimed to identify both parallels and distinctions between PSU and established addiction criteria (DSM-5 and ICD-11), to critically examine the appropriateness of applying these criteria to PSU, and to explore potential etiological factors. Methods:Semi-structured interviews were conducted with 28 university students from 17 European countries who scored above the established cut-off values for problematic smartphone use on the Smartphone Addiction Scale-Short Version (SAS-SV; >31 for males and >33 for females). Thematic analysis was applied to explore patterns of meaning across participants' accounts. Results:Participants reported addiction-like symptoms, including craving, salience and preoccupation, negative consequences, loss of control, coping, and tolerance- and withdrawal-like experiences. In addition, the smartphone's vital roles in daily life, habitual use, and its role as a disruptive distraction were highlighted. A substantial proportion of participants described experiences consistent with multiple DSM-5 or ICD-11 addiction criteria; however, all participants emphasized substantial positive consequences of smartphone use, often outweighing the negative. A central "trade-off process" between positive and negative consequences emerged, alongside motives and perceived social norms, as key elements in PSU etiology. Discussion and conclusions:Findings suggest that directly and uncritically applying existing DSM-5 or ICD-11 addiction criteria to PSU warrants careful empirical and conceptual scrutiny. Future research should move beyond existing addiction criteria to also address the dynamic balance between benefits and harms, and the roles of motives and social norms in shaping use patterns.
Background and Aims:Identifying employees at risk for work addiction is critical for early intervention, yet systematic screening approaches face practical challenges for organizations. This study compared two screening strategies: a demographic-only model that requires no additional data collection versus a psychosocial model that incorporates job satisfaction and job stress assessments. Methods:We analyzed data from employees across 85 countries or territories. Dataset 1 (psychosocial model, n = 22,136) included demographic, occupational, and psychosocial variables. Dataset 2 (demographic model, n = 23,219) used only readily available information. Work addiction risk was assessed using the International Work Addiction Scale. Five machine learning algorithms (Logistic Regression, Random Forest, XGBoost, Neural Networks, Ensemble Voting) were evaluated on both full and Elastic Net-selected feature sets using cross-validation. Results:The psychosocial model demonstrated superior performance. The best-balanced model (Logistic Regression with Elastic Net selection) achieved balanced accuracy of 0.72 ± 0.01, AUC-ROC of 0.80 ± 0.01, and Youden's J of 0.45 ± 0.02, correctly identifying 72.7% of at-risk individuals while maintaining 72.2% specificity. The demographic model demonstrated moderate performance (Ensemble Voting: balanced accuracy 0.61 ± 0.01, AUC-ROC 0.65 ± 0.01), yet retained practical utility, detecting 57.0% of at-risk cases. High-sensitivity configurations achieved detection rates of 71%, but with elevated false-positive rates, presenting important trade-offs for screening design. Discussion and Conclusions:While psychosocial variables provide superior prediction, demographic-only models offer a practical screening alternative that can identify over half of at-risk individuals without an additional data-collection burden. This trade-off between predictive performance and implementation feasibility has important implications for organizational screening programs.
The Saini-Hodgins Addiction Risk Potential of Games (SHARP-G) is a recently developed instrument designed to assess the addictive potential of video games based on their structural characteristics. While the novel instrument is highly valuable, its applicability may pose several challenges. In this work, we introduce the SHARP-G-R, a revised version featuring modifications of selected items and an overall simplification of language to improve clarity and accessibility. This updated iteration enhances the interpretability of the items, removes those with limited empirical support, and introduces new items that capture additional relevant features that may contribute to the addictive potential of games. The commentary outlines all modifications made and provides a detailed rationale for each of them. By refining the instrument, the authors aim to contribute to the discourse on the role of game design in the development and maintenance of gaming-related harms, highlighting the ethical responsibilities of the gaming industry in fostering safer gaming environments.
Background and aims:Food addiction (FA) likely contributes to obesity within a complex system of psychological, behavioral, and physiological factors. However, interactions among these factors remain incompletely understood. This study used a network approach to identify interrelationships among FA, eating motives, lifestyle habits, and weight indicators in a developmental youth cohort. Methods:A longitudinal panel study was conducted in Eastern China. Youth aged >8 years (mean ages 13-14 years) completed survey and anthropometric measurements. The Chinese version of the dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C 2.0), Kids Palatable Food Eating Motive Scale (K-PEMS) and Mindful Eating Scale for Children (MEQ-C) were used to measure addictive eating motives and behaviors. Semi-quantitative food intake, physical activity and sleep duration were assessed, and height and weight were measured by trained researchers to calculate a Body Mass Index Z score (BMIZ). Body composition measurement utilized bioelectrical impedance for detecting subcutaneous fat content (FC) and a visceral fat level (VFL). Network analysis, including cross-sectional network estimation at each time point, longitudinal network comparison, and cross-lagged panel network (CLPN) modeling, was used to examine the centrality, connectivity, and temporal relationships among FA and key variables. Results:Among the 2680 participants enrolled, 2054 completed both waves of surveys (retention rate: 76.7%; 49.5% girls). In the baseline (T1) cross-sectional network, FA showed the highest closeness and betweenness and was linked to the weight-related subnetwork (BMIZ, FC, and VFL) primarily through VFL. The follow-up (T2) cross-sectional network showed a broadly similar overall pattern. Longitudinal comparison suggested generally stable centrality patterns across time, with lifestyle-related factors showing relatively greater prominence at T2. In the CLPN, the strongest directional paths primarily extended from FA to later eating motives, whereas direct longitudinal paths from FA to weight indicators were not observed. FA and mindful eating exhibited bidirectional relationships, and mindful eating was also negatively associated with subsequent reward-based eating motives. Conclusion:FA may represent an important intervention target within the broader obesity-related psychobehavioral system in youth, particularly in relation to eating motives and reward-driven eating processes. Interventions that address FA together with mindful eating and modifiable lifestyle factors may offer a more comprehensive approach to youth weight-related health.
Background and Aims:Problematic social media use (PSMU) has been associated with emotional and behavioral difficulties, yet its relationship with cognitive performance remains insufficiently understood. This study examined whether PSMU is associated with deficits in selective attention and inhibitory control, and whether sex moderates these associations. Methods:A total of 943 Spanish young adults (18-35 years) completed the Bergen Social Media Addiction Scale (BSMAS) and two computerized tasks: the Stroop task, assessing selective attention, and the Simon task, assessing inhibitory control. Correlational and multiple regression analyses examined associations between PSMU severity, cognitive performance, age, and daily social media time of use. Moderation analyses examined sex differences. Results:PSMU showed a positive correlation with Stroop reaction times (r = .65, p < .05), indicating a positive relationship between attentional interference and PSMU scores. However, in regression models, greater daily social media time of use, rather than PSMU severity, was the only significant correlate of slower Stroop performance (β = .28, p < .001). No significant associations were found between PSMU and Simon task performance. A significant Sex × PSMU interaction (β = .14, p = .018) indicated that the association between PSMU and slower Stroop performance was stronger among women than among men. Discussion and Conclusions:Selective attention appeared to be more closely associated with daily social media time of use than inhibitory control. Our findings underscore the need to distinguish between problematic use and overall time of use when assessing cognitive correlates.
Background and aims: Obesity and food/eating addiction are associated with deficits in inhibitory control mechanisms manifested in the lateral prefrontal cortex (LPFC) bilaterally. We explored abnormalities in the functional coherence between the hemispheres and within each of them. Methods: Resting-state electroencephalography (EEG) was utilized to examine intra-and inter-hemispheric frontal brain coherence in individuals with obesity and food/eating addiction (FAOB, n = 27), those with obesity without addiction (Non-FAOB, n = 11), and healthy controls (HC, n = 15). Participants were included in this study following assessment of their BMI and Yale Food Addiction Scale (YFAS) scores. In addition, depressive symptoms were measured with the Beck Depression Inventory (BDI). Results: Individuals with obesity (FAOB and Non-FAOB combined) exhibited higher interhemispheric frontal (IF) and right frontal (RF) coherence compared to healthy controls. Within the obesity group, Non-FAOB participants showed higher IF and RF coherence than the FAOB group. These results remained significant after controlling for BDI scores. Depressive symptoms in the FAOB group were higher than those of the HC group. Discussion: Elevated frontal coherence, both between the frontal hemispheres and within the right frontal hemisphere, may be associated with effortful cognitive control and possibly a compensatory neurocognitive correlate associated with differential susceptibility to developing addictive-like overeating. Conclusions: Frontal brain coherence patterns represent candidate neurophysiological correlates of differential vulnerability to addictive-like overeating in individuals with overweight/obesity and warrant longitudinal investigation to establish their prognostic value.
Background:Approach-bias modification (ApBM) is a cognitive training intervention with potential therapeutic value for internet gaming disorder (IGD). However, its clinical efficacy and the underlying neural mechanisms remain to be systematically investigated. This study aimed to evaluate the effectiveness of ApBM for IGD and to identify the associated multi-scale neurobiological signatures, from brain connectivity to gene expression. Methods:We conducted a randomized controlled trial involving individuals with IGD assigned to either an ApBM (N = 30) or a control group (N = 27). Resting-state functional magnetic resonance imaging data were collected pre- and post-intervention. We applied non-negative matrix factorization and a machine learning framework to identify intervention-related functional connectivity patterns. Imaging-transcriptomic analysis was then used to explore the molecular foundations of the identified neural signature. Results:The ApBM intervention led to a reduction in IGD symptoms and craving. A specific functional connectivity pattern, characterized by anti-connectivity between the visual and ventral attention network (VAN), was identified via machine learning as a potential neural marker of the intervention. This pattern's statistical significance under conservative permutation test was (p = 0.06-0.08). It was spatially coupled to genes enriched in neurodevelopmental and synaptic transmission processes. Conclusions:This study provides multi-scale evidence supporting ApBM as an intervention for IGD. The remodeling between vision and the VAN may reflect a mechanism that interrupts the automatic capture of attention by gaming cues, a process regulated by genes associated with neuroplasticity. We propose a circuit-to-gene framework for understanding ApBM in IGD, though the identified neural signature warrants further independent validation.
Background and aims Social media increasingly shapes body image by promoting often unattainable beauty ideals. Concurrently, targeted online marketing of image- and performance-enhancing drugs (IPEDs) exploits these vulnerabilities, intensifying anxiety and fostering maladaptive behaviours such as problematic usage of the internet (PUI), compulsive exercise, and IPEDs consumption. This study explores these behaviours across nine countries and examines how PUI, excessive exercise, and IPEDs use predict appearance anxiety, aiming to inform targeted prevention strategies for at-risk populations. Methods A total of 3,514 participants from nine countries completed a web-based survey assessing sociodemographic data, appearance anxiety (AAI), problematic internet use (PIUQ-9), excessive exercise (EAI-R), and IPEDs intake. Results Appearance-related anxiety was observed in 12% of the participants, with the highest prevalence in Mexico (20.7%), Japan (13.8%) and Italy (13.6%). Median PUI scores were highest in Mexico (22.57) and Singapore (21.59). Excessive exercise was reported by 3.6% with no significant country differences. IPEDs use was reported by 28.3% of the sample, with the highest rates in Japan (60.6%). Logistic regression analyses revealed that PUI, excessive exercise and IPEDs use were significant predictors of appearance-related anxiety. Discussion and conclusions The strong associations between PUI, excessive exercise, IPEDs use, and appearance anxiety underscore the complex interplay between online exposure, body image concerns and mental health. Cross-country differences suggest that socio-cultural factors influence appearance-related anxiety. These findings highlight the need for culturally sensitive interventions and policy measures that address the impact of digital media on body image, particularly to protect vulnerable populations.
Background and Aims:Associations between problematic internet use (PIU) and borderline personality disorder (BPD) have been reported, but the literature is highly heterogeneous, with some studies assessing overall BPD severity and others examining individual traits (e.g., emotional lability, impulsivity, dissociation). This review synthesizes these approaches using the Alternative Model of Personality Disorders (AMPD), examining how BPD-relevant pathological personality traits (Criterion B) and impairments in self and interpersonal functioning (Criterion A) relate to PIU. Methods:Following PRISMA 2020 guidelines, we searched PsycINFO, Web of Science, PubMed, Embase, and Scopus for studies examining associations between PIU (e.g., general use, social media, gaming, smartphone use) and personality traits or functioning in adults. Study quality was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results:Thirty studies (N = 21,358) met inclusion criteria. Emotional lability and impulsivity showed the most consistent associations with PIU across outcome types. Few studies examined impairments in personality functioning, but available evidence suggests that identity disturbance may predict PIU over time and that interpersonal dysfunction is associated with greater use of online environments for reassurance and emotion regulation. Associations involving dissociation and detachment were relatively weak and less consistent. Discussion and Conclusions:Studies varied widely in design, measures, and theoretical approach, limiting direct comparison across studies. Despite this heterogeneity, findings indicate that emotional lability, impulsivity, and identity disturbance appear to represent transdiagnostic vulnerabilities that increase risk for PIU and shape patterns of online engagement.
Studying the molecular basis of Internet Use Disorders is still in its beginnings. Animal research relying on an operant light self-administration paradigm proposed by Tam et al. (2025) might provide much needed insights helping to elucidate the molecular basis underlying excessive online behavior. Despite the potential of this approach, also ethical aspects of such research need to be considered. Finally, it is not clear to what extent observations using operant light self-administration paradigms in animals can be really transferred to humans.
Background:Compulsive sexual behavior disorder (CSBD) involves uncontrollable sexual urges and behaviors that cause distress or functional impairment. Although classified as an impulse control disorder in ICD-11, its neurobiological basis and cognitive deficits remain poorly understood. Advances in large language models (LLMs) enable scalable literature parsing and multimodal neuroimaging synthesis. This study applied an LLM-based framework for coordinate-based meta-analysis and functional decoding to generate a brain-cognition mapping of CSBD that links neurobiological alterations with cognitive dysfunctions. Methods:Relevant structural and functional neuroimaging studies of CSBD were identified through semantic screening in Neurosynth Compose. Coordinates were extracted and synthesized using Multi-level Kernel Density Analysis (MKDA-χ2), with subgroup analyses conducted by study characteristics. The resulting brain maps were then functionally annotated in NeuroVault to identify associated cognitive, emotional, motivational, and behavioral dimensions. Results:Meta-analysis revealed consistent abnormalities in the left hippocampus, inferior parietal lobule, precentral gyrus, putamen, and angular gyrus, and in the right globus pallidus and supramarginal gyrus. Task-based studies mainly implicated the inferior parietal lobule, hippocampus, and globus pallidus, whereas resting-state studies indicated cerebellar involvement. In European samples, abnormalities appeared in the globus pallidus, precentral gyrus, and hippocampus, while East Asian samples showed alterations in the inferior parietal lobule and precuneus. Functional decoding linked these patterns to motivational delay, anxiety, social interaction, and response inhibition. Conclusion:CSBD may reflect a dual dysregulation mechanism involving hyperactivation of the striato-limbic reward-motivation circuitry and impaired top-down control within the frontoparietal network, together promoting persistent and compulsive sexual behaviors.
Background and Aims:Gambling disorder (GD) is a growing public health concern, with emerging evidence suggesting potential sex differences in clinical presentation, gambling preferences, and treatment-seeking patterns. Furthermore, non-Western countries/cultures and women's clinical populations are understudied. Therefore, this study aimed to examine sex-related sociodemographic characteristics, gambling behaviors, and psychiatric symptoms among treatment-seeking individuals with GD in Türkiye. Methods:Data from 12,505 treatment-seeking individuals who registered for Green Crescent Counselling Center between 2021 and 2024 were analyzed. A total of 330 women participants who met the inclusion criteria were identified and compared with a sample of 990 men participants (matched on age, marital status, and education). Sociodemographic and clinical features, gambling preferences, and psychiatric symptoms were compared between groups. Results:A notable increase in the number and proportion of women seeking-treatment for GD was observed between 2021 and 2024. Women reported beginning gambling at a later age and engaging in it for a shorter duration compared to men. They showed a distinct gambling pattern, with a strong preference for online casino games, whereas men primarily engaged in sports betting. Women also exhibited higher rates of co-occurring psychiatric concerns, including depression, anxiety, PTSD, along with greater impulsivity. Discussion and Conclusions:Our findings highlight meaningful sex-related differences in the clinical presentation and gambling behaviors of treatment-seeking individuals with GD. The sizable representation of women suggests the need for sex-sensitive prevention and intervention strategies. Tailored approaches that address co-occurring psychiatric concerns, gambling preferences, and speculative motivations, may enhance treatment outcomes and inform future service provision in the treatment of GD, particularly for women.
