Social-networks use as adaptive or maladaptive strategy for coping with stress.

Social networks are frequently used to distract, procrastinate, or cope with stress. We aimed to investigate how (problematic) social-networks use affect stress perception in interaction with different stress recovery conditions. A total of 104 participants were randomly assigned to one of four groups. Three groups underwent a stress induction with subsequent stress recovery via (1) using Facebook, (2) reading magazines, or (3) waiting. Another group (4) waited without stress induction. Stress perception was repeatedly assessed with the State-Trait-Anxiety-Inventory. Facebook use and reading magazines decreased acute stress indicating adaptive coping strategies. Stress-recovery conditions and symptom severity showed significant interactions. Facebook use was not effective for individuals with high symptom severity in contrast to non-digital strategies or for individuals with low symptom severity. The usage of social networks may be an adaptive strategy for coping with stress for some people, it is maladaptive for individuals having a problematic usage.

Cue-reactivity to distal cues in individuals at risk for gaming disorder.

BACKGROUND: Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used. METHODS: We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective. FINDINGS: We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups. INTERPRETATION: The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.

Implicit cognitions in problematic social network use.

Implicit cognitions may be involved in the development and maintenance of specific Internet use disorders such as problematic social network use (PSNU). In more detail, implicit attitude, attentional biases, approach and avoidance tendencies as well as semantic memory associations are considered relevant in the context of PSNU. This viewpoint article summarizes the available literature on implicit cognitions in PSNU. We systematically reviewed articles of implicit cognitions in PSNU from PubMed, Scopus, Web of Science, and ProQuest databases based on a targeted search strategy and assessed using predefined inclusion and exclusion criteria. The present findings suggest that specific implicit cognitions are important in the context of PSNU and therefore show parallels to other addictive behaviors. However, the empirical evidence is limited to a few studies on this topic. Implicit cognitions in PSNU should be explored in more depth and in the context of other affective and cognitive mechanisms in future work.

A systematic review and meta-analysis of risky decision-making in specific domains of problematic use of the internet: Evidence across different decision-making tasks.

This systematic review summarizes empirical evidence on risky decision-making (objective risk and ambiguity) in specific domains of problematic use of the internet (PUI) focusing on online addictive behaviors. We conducted a pre-registered (PROSPERO: CRD42020188452) PubMed search for PUI domains: gaming, social-network use, online buying-shopping, online pornography use, and unspecified PUI. We used the Newcastle-Ottawa Scale for quality assessment. Relevant studies were identified only for gaming (n = 19), social-network use (n = 8), unspecified PUI (n = 7), and online gambling (n = 1). The meta-analyses included 25 studies (2498 participants) comparing PUI and control groups regarding decision-making performance under objective risk and ambiguity. Across PUI domains, individuals with PUI compared to control participants showed more disadvantageous decision-making in measures of objective risk (g = -0.42 [-0.69, -0.16], p = .002) but not ambiguity (g = -0.22 [-0.47, -0.04], p = .096). PUI domain and gender were significant moderators. In the risk domain, effects were particularly present in gaming disorder, especially in exclusively male samples. Overall, the paucity of empirical studies in the considered area necessitates further research to identify probable gender- and disorder-specific cognitive relationships.

The fear in desire: linking desire thinking and fear of missing out in the social media context.

According to the Elaborated Intrusion Theory of Desire, desire thinking and an associated deficit are fundamental factors to the emergence of craving. In the special case of problematic social networking sites (SNS) use, this experienced deficit could be constituted of an online-specific fear of missing out (FoMO). To test the interaction of these cognitions and their influence on problematic SNS use, we tested a serial mediation model on a sample of N = 193 individuals who use SNS (73% female, Mage = 28.3, SD = 9.29). We found that desire thinking predicted FoMO and both variables were only significant predictors of problematic SNS use when considered in interplay with craving. Ad hoc analyses revealed that the verbal subcomponent of desire thinking is more strongly associated with FoMO than imaginal prefiguration. Our results highlight that neither desire thinking nor FoMO are inherently dysfunctional but become problematic when they increase craving for potentially problematic SNS use.

Online compulsive buying-shopping disorder and social networks-use disorder: More similarities than differences?

BACKGROUND: Studies in convenience, non-clinical samples of young adults suggest overlap between online compulsive buying-shopping disorder (OCBSD) and social-networks-use disorder (SNUD). Considering the dearth of research, this study investigated OCBSD and SNUD in clinical samples. METHODS: Women with either OCBSD (n = 37) or SNUD (n = 41) were compared regarding sociodemographic variables, use time of the first-choice application, OCBSD/SNUD severity, general internet use, impulsivity, materialism, perceived chronic stress and the frequency of viewing posts of influencers and the urge to visit shopping websites or social networks after viewing influencer posts. RESULTS: Women in the OCBSD group were older, more often employed, had less often a qualification for university entrance, indicated a lower daily use time of the first-choice application and higher materialistic values as compared to those in the SNUD group. No group differences emerged regarding general internet use, impulsivity and chronic stress. Regression models indicate that chronic stress predicted the symptom severity in the SNUD but not in the OCBSD group. The SNUD group reported a higher frequency of viewing influencer posts as compared to the OCBSD group. The urge for online shopping or using social networks after viewing influencer posts did not significantly differ between both groups. CONCLUSION: The findings suggest commonalities and distinct features of OCBSD and SNUD which require further investigation.

The experience of gratification and compensation in addictive behaviors: How can these experiences be measured systematically within and across disorders due to addictive behaviors?

BACKGROUND: Beyond gaming disorder and gambling disorder, pornography-use disorder, buying-shopping disorder, and social-networksuse disorders are discussed as further disorders due to addictive behaviors. For addictive behaviors, it is assumed that the experience of gratification and the experience of compensation due to the specific behavior represent reinforcing processes involved in the development and maintenance of the problematic behaviors. We aimed to develop two questionnaires that capture the experienced gratification and experienced compensation while using online activities. We additionally assume significant relationships with further addiction-related constructs such as symptom severity, use expectancies, and craving experiences. METHODS: We conducted three studies for the development of the "Experience of Gratification Scale" (EGS) and the "Experience of Compensation Scale" (ECS). In each study, participants answered the questionnaires modified for their preferred online activity (gaming, gambling, buying-shopping, social-networks use, pornography use). Additional questionnaires were used, assessing further addiction-related constructs. RESULTS: The results of the gradual approach by using exploratory and confirmatory factor analyses indicated for both scales a two-factor solution resulting in "gratification of needs" and "experience of pleasure" for the EGS, and "compensation of needs" and "experience of relief from negative feelings" for the ECS. The factors were significantly correlated with each other as well as with craving experiences, use expectancies, and symptom severity. Moreover, we found significant differences in the experienced gratification and experienced compensation for specific online behaviors. CONCLUSION: The theoretically plausible specific factors for experienced gratification and experienced compensation could be identified and were related to constructs considered important in addictive online behaviors. Further studies should investigate the relevance of these constructs for different types of addictive behaviors, but also within the addiction process addressing specific needs and motives as well as further positive and negative reinforcement mechanisms.

Assessment of Criteria for Specific Internet-use Disorders (ACSID-11): Introduction of a new screening instrument capturing ICD-11 criteria for gaming disorder and other potential Internet-use disorders.

Background and aims: With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may also be applied to other potential specific Internet-use disorders, which may be classified in ICD-11 as other disorders due to addictive behaviors, such as online buying-shopping disorder, online pornography-use disorder, social-networks-use disorder, and online gambling disorder. Due to the heterogeneity in existing instruments, we aimed to develop a consistent and economic measure of major types of (potential) specific Internet-use disorders based on ICD-11 criteria for gaming disorder. Methods: The new 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) measures five behavioral addictions with the same set of items by following the principles of WHO's ASSIST. The ACSID-11 was administered to active Internet users (N = 985) together with an adaptation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and screeners for mental health. We used Confirmatory Factor Analyses to analyze the factor structure of ACSID-11. Results: The assumed four-factorial structure was confirmed and was superior to the unidimensional solution. This applied to gaming disorder and to the other specific Internet-use disorders. ACSID-11 scores correlated with IGDT-10 as well as with the measures of psychological distress. Discussion and Conclusions: The ACSID-11 seems to be suitable for the consistent assessment of (potential) specific Internet-use disorders based on ICD-11 diagnostic criteria for gaming disorder. The ACSID-11 may be a useful and economic instrument for studying various behavioral addictions with the same items and improving comparability.

Decision Making and Risk Propensity in Individuals with Tendencies towards Specific Internet-Use Disorders.

The uncontrolled use of specific Internet applications is increasingly recognized as a mental health issue. Gaming disorder, which is one subtype of specific Internet-use disorders (sIUDs), has been included in the ICD-11 as disorder due to addictive behaviors. Addictive disorders are assumed to be accompanied by cognitive deficits as indicated by weaker performance in executive function and risky decision-making tasks. This study investigates risky decision-making in individuals with tendencies towards sIUDs including gaming, online buying-shopping, and social-networks-use disorders. A total of 293 individuals participated in the study. Based on specific screening instruments, the participants were assigned to a group with tendencies towards sIUD or a control group. Participants completed a risky decision-making task and questionnaires assessing risk-taking propensity, impulsivity, psychopathology, and perceived stress. The group with sIUD tendencies showed higher attentional impulsivity and higher levels of depression and anxiety compared to the control group. The groups did not differ in decision making and risk propensity. Decision making did not have significant effects on sIUD symptoms. Risk for developing sIUDs does not appear to be accompanied by altered general decision-making tendencies. Rather, psychological (pre-)load and attentional deficits appear to be relevant features in uncontrolled use of the Internet.

The association between problematic social networking site use, dark triad traits, and emotion dysregulation.

BACKGROUND: Social networking sites (SNSs) allow people to socially connect with each other, collaborate, and share information. However, problematic SNS use (PSNSU) may be associated with negative personality traits. The present study investigated the associations between PSNSU, dark triad personality traits, and emotion dysregulation. METHOD: In the present study, 555 SNS users (Mage = 33.32 years, SD = 10.88) completed an online survey comprising measures of PSNSU, dark triad personality traits, and emotion dysregulation. RESULTS: Bivariate correlations showed that PSNSU was significantly associated with dark triad traits as well as emotion dysregulation. Structural equation modelling (where the effect of the dark triad traits on PSNSU was mediated by emotion dysregulation) showed that 33.5% of the variance of PSNSU was explained by Machiavellianism, psychopathy, and narcissism. CONCLUSION: The findings provide suggestive evidence of why PSNSU may occur as a function of the presence of dark triad traits and emotion dysregulation. The study also highlighted the important role that emotion regulation plays in the association between dark triad traits and PSNSU.

Dispositional and online-specific Fear of Missing Out are associated with the development of IUD symptoms in different internet applications.

BACKGROUND AND AIMS: An increasing number of people experience negative consequences from the excessive use of different Internet applications or sites (e.g., Instagram, League of Legends, YouTube). These consequences have been referred to as specific Internet Use Disorders (IUDs). The present study aims to examine the Fear of Missing Out (FoMO) on rewarding experiences with respect to specific Internet activities. FoMO has been found to mediate the link between psychopathology and symptoms of Internet Communication Disorder (ICD). However, the role of FoMO in other IUDs is controversial. METHODS: The current study (N = 7,990) consecutively screened in vocational schools) analyzed the associations between online-specific state-FoMO, general trait-FoMO, mental health, and IUD symptoms in a structural equation model. After testing the model for the entire sample of Internet users, it was analyzed separately for the two main user groups: Social Networking Site (SNS) users and gamers. RESULTS: The proposed model explained 42.0% of the variance in IUD symptoms in the total sample, 46.8% for SNS users, and 32.8% for gamers. Results suggest that impaired mental health and high trait-FoMO predict IUD symptoms. For both SNS users and gamers, trait-FoMO mediated the link between low mental health and IUD, whereas state-FoMO mediated the link between trait-FoMO and IUD in both user groups. DISCUSSION: Our results partly support the theoretical model of specific IUDs, highlighting trait-FoMO as a predisposing fear of disconnection related to general mental health. Online-specific FoMO appears to contribute to problematic Internet use mainly because of its link to the general fear of disconnection. Moreover, the described mechanism seems to be comparable for both females and males. CONCLUSIONS: FoMO is a multidimensional construct underlying IUD symptoms related to the use of socially gratifying, but distinct Internet applications. FoMO and psychopathology should be targeted together in prevention and treatment plans of IUDs.

Addiction Research Unit: Affective and cognitive mechanisms of specific Internet-use disorders.

In the eleventh International Classification of Diseases (ICD-11) of the World Health Organization, gambling disorder and gaming disorder are included in the category 'disorders due to addictive behaviours', which can be specified further as occurring either predominantly offline or predominantly online. Other specific problematic behaviours may be considered for the category 'other specified disorders due to addictive behaviours'. The Research Unit FOR 2974, funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), focuses on the most prominent online addictive behaviours: gaming, pornography use, buying-shopping and social-networks use. The main goal of the Research Unit is to contribute to a better understanding of the common and differential psychological as well as neurobiological mechanisms involved in these specific types of Internet-use disorders. We aim to investigate theoretically argued (bio)psychological processes with a focus on concepts coming from research of substance-use disorders, for example, cue reactivity and craving, executive functions and specific inhibitory control, coping, implicit cognitions, and decision making. One central characteristic of the Research Unit is that we will investigate all participants using a comprehensive core battery of experimental paradigms, neuropsychological tasks, questionnaires, biomarkers, ambulatory assessment, and a 6-month follow-up survey. Beyond the anticipated contributions to the scientific understanding of the mechanisms involved in the development and maintenance of respective online addictive behaviours, we also expect contributions to clinical practice by showing which affective and cognitive mechanisms may be addressed more intensively to optimize treatment.

Social-networks-related stimuli interferes decision making under ambiguity: Interactions with cue-induced craving and problematic social-networks use.

BACKGROUND AND AIMS: Social-networks-use disorder is discussed as a potential further type of disorders due to addictive behaviors. Theoretical models assume cue-induced craving and disadvantageous decision making to be relevant mechanisms. This study investigates if the presentation of social-networks-related cues interferes with decision making under ambiguity. METHODS: Craving was induced with a cue-reactivity paradigm and assessed with a visual analogue scale. Participants (N = 146) played a modified Iowa Gambling Task with social-networks-related cues and neutral cues presented on the advantageous and disadvantageous decks respectively, or vice versa. Symptoms of social-networks-use disorder were measured with a modified version of the short Internet Addiction Test. RESULTS: Overall, participants chose options with neutral cues more often than those with social-networks-related cues, even if it was disadvantageous. There was a significant interaction between decision-making performance and Iowa Gambling Task condition in predicting symptom severity. The results indicate that choosing decks with social-networks-related cues even if it was disadvantageous is associated with higher tendencies towards a social-networks-use disorder. The interaction with cue-induced craving did not explain further variance. DISCUSSION AND CONCLUSIONS: The results highlight the relevance of cue reactivity, decision making, and their interaction as potential mechanisms explaining tendencies towards a social-networks-use disorder. Decision making was influenced by affective responses, which could result in a higher risk of a potential addictive behavior. This is consistent with the findings from addiction research and with theoretical approaches assuming an imbalance between affective and cognitive processes in addictive behaviors.

Perceived Strain Due to COVID-19-Related Restrictions Mediates the Effect of Social Needs and Fear of Missing Out on the Risk of a Problematic Use of Social Networks.

The occurrence of the COVID-19-virus led to drastic short-term measures to reduce its spread and influence. Regulations such as "physical distancing," mentioned as "social distancing," and the closure of public facilities during the lockdown could be perceived as burdensome especially by individuals who feel a strong need for social exchange and belonging. These components such as need to belong and the fear of missing out also play a major role in the development and maintenance of a problematic use of social networks. Researchers have argued recently that an increase of addictive (online) behaviors may be a likely consequence of subjectively experienced restrictions in the context of the COVID-19 pandemic. The current study investigates the interplay of perceived strain due to COVID-19-related restrictions and the fear of missing out (FoMO) as well as of symptoms of problematic social-networks use. We hypothesized that perceived strain due to COVID-19-related restrictions mediates the effect of specific predisposing variables related to social needs on the symptom severity of a problematic use. To assess the perceived strain due to COVID-19-related restrictions, we developed a specific questionnaire asking for perceived COVID-19-related strain in several domains of everyday-life. An exploratory factor analysis identified five factors: perceived strain related to restrictions of (1) social contacts, (2) travel, (3) childcare, (4) work, and (5) own health. In a sample of 719 German participants and data collection during the first COVID-19 lockdown (March 30th until April 3rd 2020), a structural equation model was calculated showing that higher levels of need to belong and FoMO increase perceived COVID-19-related strain, which is related to symptoms of a problematic social-networks use. The effect of need to belong on problematic social-networks use is mediated by experienced COVID-19-related strain and FoMO-online. Even if the use of social networks is not pathological per se, it may be associated with suffering for a vulnerable part of users. We conclude that specific needs and fear-associated predisposing variables contribute to experiencing physical distance and other pandemic-related restrictions as more stressful, which may increase problematic social-networks use and potentially other addictive behaviors as well in the context of the COVID-19-related lockdown.

Affective and cognitive processes involved in behavioral addictions.

This special issue addresses the affective and cognitive processes and their interactions potentially reflecting mechanisms underlying the development, maintenance of, or recovery from behavioral addictions. Various specific types of behavioral addictions will be considered, including those already in ICD-11 (gambling disorder, gaming disorder), but also new phenomena that are not yet classified (e.g., buying-shopping disorder, social-network-disorder) and phenomena potentially belonging to behavioral addictions although they are currently classified elsewhere (e.g., compulsive sexual behavior disorder). The articles included in this special issue directly investigate affective processes (e.g., cue-reactivity, craving, mood, stress, social interactions) and/or cognitive processes (e.g., executive functions, attention, memory). The studies involve experimental paradigms, neuropsychological tasks, psychophysiological measures, and neuroimaging techniques. Specific articles also deal with the relationship between affective and cognitive processes. The special issue is complemented by articles covering current debates and reviewing current empirical findings in the field.

Deficits in executive functions but not in decision making under risk in individuals with problematic social-network use.

BACKGROUND: The tendency to strive for immediate gratification by neglecting potential negative long-term outcomes characterizes addictive behaviors, such as substance use or gaming disorder. Problematic social-network use is currently discussed as another potential addictive behavior, which is considered to result from an imbalance between affective and cognitive processes, indicated by traits such as increased impulsivity and/or decreased executive functions and decision-making abilities. METHODS: This study investigates the respective functions in social-network users by use of the Cards and Lottery Task (CLT) - a decision-making task under risk conditions in which options contain conflicting immediate and long-term outcomes at the same time. A sample of German and Spanish participants (N = 290) performed the CLT as well as the Modified Card Sorting Test (MCST), Barratt Impulsiveness Scale (BIS), the short Internet Addiction Test specified for social-networking (sIAT-SNS), and screeners on other potentially problematic behaviors. RESULTS: Comparing extreme groups based on sIAT-SNS scores (1SD above/below mean), individuals with problematic social-network use (n = 56), as compared to those with non-problematic social-network use (n = 50), showed increased attentional impulsivity and reduced executive functions. No differences were observed in decision-making performance. CONCLUSION: The findings indicate that problematic social-network use is related to attentional rather than general decision-making deficits. Furthermore, problematic social-network use is likely to co-occur with other problematic Internet-use behaviors, particularly gaming or shopping.

How to overcome taxonomical problems in the study of Internet use disorders and what to do with "smartphone addiction"?

AIMS: The present theoretical paper introduces the smartphone technology as a challenge for diagnostics in the study of Internet use disorders and reflects on the term "smartphone addiction." METHODS: Such a reflection is carried out against the background of a literature review and the inclusion of Gaming Disorder in ICD-11. RESULTS: We believe that it is necessary to divide research on Internet use disorder (IUD) into a mobile and non-mobile IUD branch. This is important because certain applications such as the messenger application WhatsApp have originally been developed for smartphones and enfold their power and attractiveness mainly on mobile devices. DISCUSSION AND CONCLUSIONS: Going beyond the argumentation for distinguishing between mobile and non-mobile IUD, it is of high relevance for scientists to better describe and understand what persons are actually (over-)using. This is stressed by a number of examples, explicitly targeting not only the diverse contents used in the online world, but also the exact behavior on each platform. Among others, it matters if a person is more of an active producer of content or passive consumer of social media.

Desire thinking promotes decisions to game: The mediating role between gaming urges and everyday decision-making in recreational gamers.

INTRODUCTION: Desire thinking is a voluntary cognitive process that involves the imaginal forecast of a desired activity and the verbal perseveration with plans and good reasons for engaging in it. Considering theoretical models arguing that specific decision-making processes may be involved in the development of gaming disorder, we hypothesized that an initial urge to game might be accelerated by desire thinking, leading to the decision to game in an everyday setting although the gaming behavior may conflict with another activity or certain other goals. METHODS: A pre-study helped developing a catalogue of situations that provides forced-choice scenarios warranting a decision for or against gaming. To explore the postulated sequence of cognitive and affective events, a serial mediation model with urge to game as predictor, decision to game as dependent variable, and imaginal prefiguration and verbal perseveration as mediators was tested in a sample of 118 recreational gamers with varying degrees of gaming intensity. RESULTS: The pre-study revealed a catalogue of 18 conflicting situations that likely happen in the daily life of gamers, containing conflicting activities such as job/educational performance and meeting friends/family/acquaintances. In the sequential mediation model, the desire thinking facets imaginal prefiguration and verbal perseveration fully mediated the relation between an initial urge and the decision to game. CONCLUSIONS: The mediation model emphasizes the serial ordinance of desire thinking facets and their role in motivating decisions to game after an initial urge has been experienced. Results may indicate that desire thinking plays a considerable role in problematic gaming tendencies.

A Randomized Study of Food Pictures-Influenced Decision-Making Under Ambiguity in Individuals With Morbid Obesity.

BACKGROUND AND AIMS: In addition to craving responses to salient food cues, the anticipation of short-term rewarding consumption of palatable food may overrun the anticipation of long-term negative consequences of obesity. The present investigation addressed the potential interplay of food cravings and decision-making abilities in individuals with obesity. METHOD: Study 1 included 107 bariatric surgery candidates with class 2/3 obesity (OB-group) and study 2 included 54 individuals with normal weight/pre-obesity (nonOB-group). In both studies, standardized questionnaires concerning food cravings, food addiction, and psychopathology were administered. A cue-reactivity paradigm was used to measure craving responses toward semi-individualized images of highly palatable, processed food/fruit (appetitive food cues) compared to images of raw vegetables (non-appetitive food cues). Decision-making was measured with a modified computerized version of the Iowa Gambling Task (IGT) with food pictures. Both groups were divided into two subgroups that were randomized to different IGT conditions. In one IGT condition the advantageous IGT card decks were covered by pictures of palatable, processed food or fruit and the disadvantageous decks by images of raw vegetables (= congruent condition), and in the other IGT condition vice versa. RESULTS: Participants in the OB-group admitted on average higher craving responses toward palatable, processed food or fruit cues compared to pictures of raw vegetables. This was not the case in the nonOB-group. Contrary to our hypothesis, decision-making performance in both groups was worse when pictures of palatable, processed food or fruit were associated with advantageous IGT card decks compared to performance when those pictures were linked to the disadvantageous decks. The interference effect of food pictures processing on advantageous decision-making has been observed particularly in those individuals of the OB-group who exhibited high craving responses toward palatable, processed food cues or high levels of food addiction. DISCUSSION: The results indicate that food pictures processing interferes with decision-making, regardless of weight status. Opposed to the hypothesis, stronger tendencies to avoid than to approach pictures presenting processed, tasty food were observed. Further research should examine how cognitive avoidance tendencies toward processed, high energy food and approach tendencies toward healthy food can be transferred to real life situations.

Which conditions should be considered as disorders in the International Classification of Diseases (ICD-11) designation of "other specified disorders due to addictive behaviors"?

BACKGROUND: Gambling and gaming disorders have been included as "disorders due to addictive behaviors" in the International Classification of Diseases (ICD-11). Other problematic behaviors may be considered as "other specified disorders due to addictive behaviors (6C5Y)." METHODS: Narrative review, experts' opinions. RESULTS: We suggest the following meta-level criteria for considering potential addictive behaviors as fulfilling the category of "other specified disorders due to addictive behaviors":1. Clinical relevance: Empirical evidence from multiple scientific studies demonstrates that the specific potential addictive behavior is clinically relevant and individuals experience negative consequences and functional impairments in daily life due to the problematic and potentially addictive behavior.2. Theoretical embedding: Current theories and theoretical models belonging to the field of research on addictive behaviors describe and explain most appropriately the candidate phenomenon of a potential addictive behavior.3. Empirical evidence: Data based on self-reports, clinical interviews, surveys, behavioral experiments, and, if available, biological investigations (neural, physiological, genetic) suggest that psychological (and neurobiological) mechanisms involved in other addictive behaviors are also valid for the candidate phenomenon. Varying degrees of support for problematic forms of pornography use, buying and shopping, and use of social networks are available. These conditions may fit the category of "other specified disorders due to addictive behaviors". CONCLUSION: It is important not to over-pathologize everyday-life behavior while concurrently not trivializing conditions that are of clinical importance and that deserve public health considerations. The proposed meta-level-criteria may help guide both research efforts and clinical practice.