Learning to lose control: A process-based account of behavioral addiction

Neurosci Biobehav Rev. 2020 Jan:108:771-780. doi: 10.1016/j.neubiorev.2019.12.025. Epub 2019 Dec 14.

Abstract

Learning psycho(bio)logy has developed a solid corpus of evidence and theory regarding behavior control modes. The present article briefly reviews that literature and its influence on recent models in which the transition from goal-directed to compulsive behavior is identified as the main process underlying substance use disorders. This literature is also relevant to non-substance addictive disorders, and serves as basis to propose a restricted definition of behavioral addiction relying on the presence of behavior-specific compulsivity. Complementarily, we consider whether some activities can become disordered while remaining mostly goal-driven. Based on reinforcement learning models, relative outcome utility computation is proposed as an alternative mechanism through which dysfunctional behaviors (even not qualifying as addictive) can override adaptive ones, causing functional impairment. Beyond issues of conceptual delimitation, recommendations are made regarding the importance of identifying individual etiological pathways to dysregulated behavior, the necessity of accurately profiling at-risk individuals, and the potential hazards of symptom-based diagnosis. In our view, the validity of these recommendations does not depend on the position one takes in the nosological debate.

Keywords: Behavioral addiction; Behavioral control modes; Compulsivity; Learning; Non-substance addictive disorders; Reinforcement learning.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Behavior, Addictive / physiopathology*
  • Executive Function / physiology*
  • Humans
  • Models, Psychological*
  • Reinforcement, Psychology*