Current Addiction Reports

, Volume 6, Issue 3, pp 331–337 | Cite as

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

  • Hans-Jürgen RumpfEmail author
  • Dominique Brandt
  • Zsolt Demetrovics
  • Joël Billieux
  • Natacha Carragher
  • Matthias Brand
  • Henrietta Bowden-Jones
  • Afarin Rahimi-Movaghar
  • Sawitri Assanangkornchai
  • Renata Glavak-Tkalic
  • Guilherme Borges
  • Hae-Kook Lee
  • Florian Rehbein
  • Naomi A. Fineberg
  • Karl Mann
  • Marc N. Potenza
  • Dan J. Stein
  • Susumu Higuchi
  • Daniel King
  • John B. Saunders
  • Vladimir Poznyak
ICD-11 (D King, S Higuchi and V Poznyak, Section Editors)
Part of the following topical collections:
  1. Topical Collection on ICD-11


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.


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.


Behavioral addiction Epidemiology Surveys Assessment Recommendation Random error Systematic error 



Vladimir Poznyak is a staff member of the World Health Organization. The views expressed in this publication do not necessarily represent the decisions or policies of the World Health Organization.

Funding Information

This publication is based upon work from COST Action CA16207 “European Network for Problematic Usage of the Internet,” supported by COST (European Cooperation in Science and Technology: Marc Potenza has received support from the Connecticut State Department of Mental Health and Addiction Services, the Connecticut Mental Health Center, the Connecticut Council on Problem Gambling, and the National Center for Responsible Gaming. The funding agencies did not provide input or comment on the content of the manuscript, and the content of the manuscript reflects the contributions and thoughts of the authors and do not necessarily reflect the views of the funding agencies. Zsolt Demetrovics was supported by the Hungarian National Research, Development and Innovation Office (Grant No.: KKP126835).

Compliance with Ethical Standards

Conflict of Interest

Hans-Jürgen Rumpf, Dominique Brandt, Zsolt Demetrovics, Joël Billieux, Natacha Carragher, Matthias Brand, Henrietta Bowden-Jones, Afarin Rahimi-Movaghar, Sawitri Assanangkornchai, Renata Glavak-Tkalic, Guilherme Borges, Hae-Kook Lee, Florian Rehbein, Naomi A. Fineberg, Karl Mann, Marc N. Potenza, Dan J. Stein, Susumu Higuchi, Daniel King, John B. Saunders, and Vladimir Poznyak declare that they have no conflict of interest with regard to this manuscript.

Naomi Fineberg reports personal fees from Otsuka, Lundbeck, Abbott, Sun Pharma, Taylor and Francis, Elsevier; personal fees and non-financial support from RANZCP, Wiley; grants from NIHR, Wellcome; grants and non-financial support from EU, ECNP, Shire; non-financial support from BAP, WHO, CINP, ISAD, RCPsych, International College Of OC Spectrum Disorders, IFMAD, MHRA; and others from Oxford University Press, all outside the submitted work.

Marc Potenza has received financial support or compensation for the following: Dr. Potenza has consulted for and advised RiverMend Health, Opiant/Lakelight Therapeutics, and Jazz Pharmaceuticals; has received unrestricted research support from Mohegan Sun Casino and grant support from the National Center for Responsible Gaming; and has consulted for legal and gambling entities on issues related to impulse control disorders.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Hans-Jürgen Rumpf
    • 1
    Email author
  • Dominique Brandt
    • 1
  • Zsolt Demetrovics
    • 2
  • Joël Billieux
    • 3
  • Natacha Carragher
    • 4
  • Matthias Brand
    • 5
  • Henrietta Bowden-Jones
    • 6
  • Afarin Rahimi-Movaghar
    • 7
  • Sawitri Assanangkornchai
    • 8
  • Renata Glavak-Tkalic
    • 9
  • Guilherme Borges
    • 10
  • Hae-Kook Lee
    • 11
  • Florian Rehbein
    • 12
  • Naomi A. Fineberg
    • 13
  • Karl Mann
    • 14
  • Marc N. Potenza
    • 15
  • Dan J. Stein
    • 16
  • Susumu Higuchi
    • 17
  • Daniel King
    • 18
  • John B. Saunders
    • 19
  • Vladimir Poznyak
    • 20
  1. 1.Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, Research Group S:TEPUniversity of LübeckLübeckGermany
  2. 2.Institute of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
  3. 3.Addictive and Compulsive Behaviours Laboratory, Institute for Health and BehaviourUniversity of LuxembourgEsch-sur-AlzetteLuxembourg
  4. 4.Department of Mental Health and Substance AbuseWHO HeadquartersGenevaSwitzerland
  5. 5.General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR)University of Duisburg-EssenDuisburgGermany
  6. 6.Central North West London NHS Trust and Division of Brain ScienceImperial College LondonLondonUK
  7. 7.Iranian National Center for Addiction StudiesTehran University of Medical SciencesTehranIran
  8. 8.Epidemiology Unit and Centre for Alcohol Studies (INCAS), Faculty of MedicinePrince of Songkla UniversitySongkhlaThailand
  9. 9.Institute of Social Sciences Ivo PilarZagrebCroatia
  10. 10.National Institute of PsychiatryMexico CityMexico
  11. 11.Department of Psychiatry, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  12. 12.Criminological Research Institute Lower SaxonyHannoverGermany
  13. 13.University of HertfordshireUniversity of Cambridge, and Hertfordshire Partnership University NHS Foundation TrustHatfieldUK
  14. 14.Central Institute of Mental HealthUniversity of HeidelbergMannheimGermany
  15. 15.Departments of Psychiatry and Neuroscience, Child Study CenterYale University School of Medicine, and the Connecticut Council on Problem Gambling and Connecticut Mental Health CenterNew HavenUSA
  16. 16.Department of Psychiatry and Mental Health, SA MRC Unit on Risk & Resilience in Mental DisordersUniversity of Cape TownCape TownSouth Africa
  17. 17.National Hospital Organization Kurihama Medical and Addiction CenterYokosukaJapan
  18. 18.School of PsychologyThe University of AdelaideAdelaideAustralia
  19. 19.Centre for Youth Substance Abuse ResearchThe University of QueenslandBrisbaneAustralia
  20. 20.Department of Mental Health and Substance AbuseWHO HeadquartersGenevaSwitzerland

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