Finding your way in the complex area of behavioural addictions. An analytic framework to contextualize the literature
Background: The monitoring scope of the French Monitoring Centre for Drugs and Drug Addiction (OFDT) encompasses licit and illicit drugs as well as issues regarding gambling since the early 2000s. Now extending its scope of study towards other addictive behaviour, the OFDT has carried out a narrative literature review to establish an overview of the state of art.
Methods: The main potential addictive activities (gaming, social networks, internet, exercise, sexual activities, buying, work, eating) have been studied excluding gambling which is much better documented. This review focused on definitions, concepts, methodologies, and tools with a special attention to level of consensus. Searches in scientific databases were supplemented by a “snow ball” method. A wide variety of sources (grey literature, non-scientific contents from marketing professionals…) have been included. The disciplinary scope was as broad as possible beyond the health field (information and communication sciences, anthropology...).
Results: The field of addictive behaviours turned out to be marked by a large number of concepts, a multiplicity of terms, and their meanings, of definitions and of measurement tools and, finally, by a low level of consensus. Therefore, it proved necessary to elaborate a transversal analysis grid of this vast area. Three main issues can be emphasised. 1. The plurality of rationales that cross the behavioural addiction area. It involves numerous scientific disciplines (psychology, psychiatry, neuroscience, economy, sociology, computer sciences…), each with its own theoretical concepts, models and vocabulary, that are often not explicit. It also covers intersecting and interrelated skates of different natures, meeting the objectives of the diversity of the actors concerned, from pragmatic clinical issues to societal or economic issues. Seemingly disparate potential objects of addictive behaviour are delimited and referred to in a very heterogenous way. 2. The lack of consensus related to the concepts and definition criteria of addictive disorders and addiction, which are the core of measurement grids and data comparability; 3. Finally, the multicausal scattered lexical use which leads to unclear links between terms and meanings. Some experts are in relative agreement on the research needs to move towards more consensus and progress in characterising disorders: fill the gap in empirical knowledge by developing person-centred qualitative approaches and longitudinal studies and also to conduct researches on the psychopathological processes at work by drawing on theoretical models.
Conclusion: By analysing the complexity of this field, this review allows to contextualise publications and data and help understand their significance. It highlights what is at stakes in the choice of terms, diagnostic criteria or statistical tools, and addresses the challenges of recognising some so-called addictive behaviours as genuine addictions.
