Further evidence for the bidimensionality of the components model of addiction: a reply to Amendola (2023).

In our original research article entitled "Deconstructing the components model of addiction: an illustration through "addictive" use of social media" (Fournier et al., 2023), we showed that the Bergen Social Media Addiction Scale, a six-item psychometric instrument derived from the components model of addiction to assess social media "addiction", did not form a unitary, but a bidimensional construct in which some components (i.e., salience, tolerance) were not associated with psychopathological symptoms, thus conflating central and peripheral features of addiction. Subsequently, in a recent commentary, Amendola (2023) sought to determine whether our findings were driven by the use of data aggregated from multiple independent datasets, i.e., a decision we transparently acknowledged as a limitation in our original research article. Following their re-analysis, Amendola (2023) claimed to have demonstrated that a unidimensional model best fitted the data. However, they only reported results for a partial set of models relevant to this investigation. In the present reply, through a transparent assessment and reporting of all unidimensional and bidimensional models relevant to this investigation, we show that the bidimensionality of the Bergen Social Media Addiction Scale is, in fact, tenable, robust, and consistent across multiple independent datasets. In line with the growing evidence demonstrating that many sets of criteria involved in operationalizing behavioral addictions pathologize involvement in appetitive behaviors, these results highlight the necessity to renew the conceptualization and assessment of behavioral addictions.

Thinking beyond cut-off scores in the assessment of potentially addictive behaviors: A brief illustration in the context of binge-watching.

While applying a diagnostic approach (i.e., comparing "clinical" cases with "healthy" controls) is part of our methodological habits as researchers and clinicians, this approach has been particularly criticized in the behavioral addictions research field, in which a lot of studies are conducted on "emerging" conditions. Here we exemplify the pitfalls of using a cut-off-based approach in the context of binge-watching (i.e., watching multiple episodes of series back-to-back) by demonstrating that no reliable cut-off scores could be determined with a widely used assessment instrument measuring binge-watching.

Predictors of Cyberchondria During the COVID-19 Pandemic: Cross-sectional Study Using Supervised Machine Learning.

BACKGROUND: Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. It has been conceptualized as a multidimensional construct fueled by both anxiety and compulsivity-related factors and described as a "transdiagnostic compulsive behavioral syndrome," which is associated with health anxiety, problematic internet use, and obsessive-compulsive symptoms. Cyberchondria is not included in the International Classification of Diseases 11th Revision or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and its defining features, etiological mechanisms, and assessment continue to be debated. OBJECTIVE: This study aims to investigate changes in the severity of cyberchondria during the COVID-19 pandemic and identify the predictors of cyberchondria at this time. METHODS: Data collection started on May 4, 2020, and ended on June 10, 2020, which corresponds to the first wave of the COVID-19 pandemic in Europe. At the time the study took place, French-speaking countries in Europe (France, Switzerland, Belgium, and Luxembourg) all implemented lockdown or semilockdown measures. The survey consisted of a questionnaire collecting demographic information (sex, age, education level, and country of residence) and information about socioeconomic circumstances during the first lockdown (eg, economic situation, housing, and employment status) and was followed by several instruments assessing various psychological and health-related constructs. Inclusion criteria for the study were being at least 18 years of age and having a good understanding of French. Self-report data were collected from 725 participants aged 18-77 (mean 33.29, SD 12.88) years, with females constituting the majority (416/725, 57.4%). RESULTS: The results showed that the COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and compulsion increased (distress z=-3.651, P<.001; compulsion z=-5.697, P<.001), whereas the reassurance facet of cyberchondria decreased (z=-6.680, P<.001). In addition, COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic. CONCLUSIONS: These findings provide evidence of the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. In addition, they are consistent with a theoretical model of cyberchondria during the COVID-19 pandemic proposed in 2020. These findings have implications for the conceptualization and future assessment of cyberchondria.

Deconstructing the components model of addiction: an illustration through "addictive" use of social media.

The components model of addiction posits that all addictions share six components, namely salience, tolerance, mood modification, relapse, withdrawal, and conflict. This highly influential model has resulted in the development of numerous psychometric instruments that measure addictive behaviors according to these criteria. However, recent research suggests that, in the context of behavioral addictions, certain components constitute peripheral features that do not distinguish non-pathological from pathological behavior. Using "addictive" use of social media as a representative example, we examined this perspective by testing whether these six components actually assess central features of addiction, or whether some of them constitute peripheral features that are not indicative of a disorder. Four independent samples totaling 4,256 participants from the general population completed the Bergen Social Media Addiction Scale, a six-item psychometric instrument derived from the components model of addiction to assess social media "addiction". By performing structural equation modeling and network analyses, we showed that the six components did not form a unitary construct and, crucially, that some components (i.e., salience, tolerance) were not associated with measures assessing psychopathological symptoms. Taken together, these results suggest that psychometric instruments based on the components model conflate central and peripheral features of addiction when applied to behavioral addictions. This implies that such instruments pathologize involvement in appetitive behaviors. Our findings thus call for renewing the conceptualization and assessment of behavioral addictions.

Negative Affect and Problematic Binge-Watching: The Mediating Role of Unconstructive Ruminative Thinking Style.

The practice of binge-watching (i.e., watching multiple episodes of TV series in one session) has become increasingly prevalent, but comprehending its nature and potential underlying factors has been challenging. In particular, problematic binge-watching remains ill-defined and conceptualized, being regarded either as an addictive behaviour or a maladaptive emotion regulation strategy. Following a process-based approach, in the current study we explored the latter conceptualization, by investigating the potential mediating role of an unconstructive ruminative thinking style between negative affect and problematic binge-watching. To this end, TV series viewers completed an online survey assessing socio-demographic variables, TV series viewing habits, binge-watching motives and engagement, ruminative thinking styles and affect. Based on their answers, participants were allocated to one of the following three groups: non-binge-watchers (n = 59), trouble-free binge-watchers (n = 85), or problematic binge-watchers (n = 162). Group comparisons and mediation analyses were conducted to explore the underlying role of unconstructive rumination in problematic binge-watching. Results showed that, apart from the pattern of TV series watching, trouble-free binge-watchers shared little to no similarity with problematic binge-watchers, therefore supporting the need to differentiate these two behaviours. Moreover, mediation analyses revealed that an unconstructive ruminative thinking style partially mediated the relationship between negative affect and coping/escapism and that it fully accounted for the relationship between negative affect and binge-watching derived positive emotions in problematic binge-watchers. These findings thus add to the notion that problematic binge-watching might serve as a way to bolster a maladaptive emotion regulation strategy, implying that unconstructive rumination acts as a mediating process in this context.

Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet.

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.

Compulsive Sexual Behavior Disorder should not be classified by solely relying on component/symptomatic features •.

The paper by Sassover and Weinstein (2022) contributes to a timely and complex debate related to the classification of Compulsive Sexual Behavior Disorder (CSBD). The recent inclusion of CSBD as an impulse-control disorder in the ICD-11 has generated debate since a competitive view is that CSBD should rather be classified as an addictive disorder. Sassover and Weinstein (2022) reviewed existing evidence and concluded it does not support the conceptualization of CSBD as an addictive disorder. Although we agree regarding the relevance and timely nature of considering the classification of CSBD, we respectfully disagree with the position that relying on the components model of addiction (Griffiths, 2005) is the optimal approach for determining whether or not CSBD is an addictive disorder. In this commentary, we discuss potential pitfalls of relying on the components model to conceptualize CSBD as an addictive disorder and argue that considering a process-based approach is important for advancing this timely debate.

Corrigendum: Is Watching TV Series an Adaptive Coping Strategy During the COVID-19 Pandemic? Insights From an Italian Community Sample.

[This corrects the article DOI: 10.3389/fpsyt.2021.599859.].

Positive and negative urgency as a single coherent construct: Evidence from a large-scale network analysis in clinical and non-clinical samples.

AIMS: Negative and positive urgency are emotion-related impulsivity traits that are thought to be transdiagnostic factors in psychopathology. However, it has recently been claimed that these two traits are closely related to each other and that considering them separately might have limited conceptual and methodological value. The present study aimed to examine whether positive and negative urgency constructs constitute separate impulsivity traits. METHODS: In contrast to previous studies that have used latent variable approaches, this study employed an item-based network analysis conducted in two different samples: a large sample of non-clinical participants (N = 18,568) and a sample of clinical participants with psychiatric disorders (N = 385). RESULTS: The network analysis demonstrated that items denoting both positive and negative urgency cohere as a single cluster of items termed "general urgency" in both clinical and non-clinical samples, thereby suggesting that differentiating positive and negative urgency as separate constructs is not necessary. CONCLUSION: These findings have important implications for the conceptualization and assessment of urgency and, more broadly, for future research on impulsivity, personality, and psychopathology.

Is Watching TV Series an Adaptive Coping Strategy During the COVID-19 Pandemic? Insights From an Italian Community Sample.

Social distancing and lockdown due to the COVID-19 pandemic substantially impacted individuals' daily habits and well-being. Within such a context, digital technology may provide a welcome source of alternative forms of connection and entertainment. Indeed, streaming services showed a remarkable increase in membership subscriptions throughout the period considered. However, excessive involvement in watching TV series has recently become a subject of scholarly concern as it may represent an emerging form of addictive behavior with the features of what has been labeled as "binge-watching" (i.e., watching multiple episodes of TV series in a single session). The current study aimed to assess TV series watching behaviors and related motivations, as well as their relationships with depression, stress and anxiety, in a sample of Italian adults during the COVID-19 lockdown. Specifically, we aimed to explore which patterns of motivations and emotional states influenced either a high but healthy engagement in watching TV series, or promoted problematic and uncontrolled watching behavior under such circumstances. A total of 715 adults (M = 31.70, SD = 10.81; 71.5% female) from all over Italy were recruited (from 1st to 30th April 2020) through advertisements via social media platforms of Italian university communities and other online groups. Two multiple hierarchical regression analyses were performed with non-problematic and problematic TV series watching set as dependent variables. Results showed that people spent more time watching TV series during the pandemic lockdown, especially women who also reported higher levels of anxiety and stress than men. Moreover, both non-problematic (R 2 = 0.56; p < 0.001) and problematic (R 2 = 0.33; p < 0.001) TV series watching behaviors were equally induced by anxiety symptoms and escapism motivation, thereby suggesting that watching TV series during the COVID-19 lockdown probably served as a recovery strategy to face such a stressful situation. Finally, our findings also suggest that enrichment motives may protect from uncontrolled and potentially addictive watching behaviors. These findings, therefore, hold important implications, particularly for avoiding the over-pathologization of excessive involvement in online activities emerging as a result of specific distressing situations.

Overcoming the unitary exploration of binge-watching: A cluster analytical approach.

BACKGROUND AND AIMS: Binge-watching (i.e., watching multiple episodes of a TV series in one session) has recently become standard practice among TV series viewers; this expansion generates concerns regarding the potential negative outcomes associated with this habit. However, the investigation of its psychological correlates remains fragmentary, with few initial studies a priori conceptualizing this behavior as a new addictive disorder. This study explored these psychological correlates using cluster analysis of binge-watching behavior based on three key psychological factors: motivations, impulsivity, and emotional reactivity. METHODS: An online survey was completed by 4,039 TV series viewers. Data were analyzed using hierarchical and non-hierarchical cluster analyses, the validity of the clusters being finally determined through mutual comparisons with a selection of external correlates. RESULTS: Four clusters were identified: recreational TV series viewers (presenting low involvement in binge-watching), regulated binge-watchers (moderately involved), avid binge-watchers (presenting elevated but non-problematic involvement), and unregulated binge-watchers (presenting potentially problematic involvement associated with negative outcomes). DISCUSSION AND CONCLUSIONS: This study underlines the heterogeneous and multidetermined nature of binge-watching. Our findings suggest that high engagement in binge-watching is distinct from problematic binge-watching, thus reinforcing the notion that conceptualizing binge-watching as an addictive disorder is of low relevance and might actually lead to the overpathologization of this highly popular leisure activity.

Toward a qualitative understanding of binge-watching behaviors: A focus group approach.

Background and aims Binge-watching (i.e., seeing multiple episodes of the same TV series in a row) now constitutes a widespread phenomenon. However, little is known about the psychological factors underlying this behavior, as reflected by the paucity of available studies, most merely focusing on its potential harmfulness by applying the classic criteria used for other addictive disorders without exploring the uniqueness of binge-watching. This study thus aimed to take the opposite approach as a first step toward a genuine understanding of binge-watching behaviors through a qualitative analysis of the phenomenological characteristics of TV series watching. Methods A focus group of regular TV series viewers (N = 7) was established to explore a wide range of aspects related to TV series watching (e.g., motives, viewing practices, and related behaviors). Results A content analysis identified binge-watching features across three dimensions: TV series watching motivations, TV series watching engagement, and structural characteristics of TV shows. Most participants acknowledged that TV series watching can become addictive, but they all agreed having trouble recognizing themselves as truly being an "addict." Although obvious connections could be established with substance addiction criteria and symptoms, such parallelism appeared to be insufficient, as several distinctive facets emerged (e.g., positive view, transient overinvolvement, context dependency, and low everyday life impact). Discussion and conclusion The research should go beyond the classic biomedical and psychological models of addictive behaviors to account for binge-watching in order to explore its specificities and generate the first steps toward an adequate theoretical rationale for these emerging problematic behaviors.