What counts as an addiction — should compulsive shopping or gaming qualify?
Researchers are currently debating whether to classify problematic behaviors as addictions in the next edition of psychiatry’s “bible” of mental health disorders. The current version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, DSM-5, includes gambling disorder as a behavioral addiction, while all other addictions mentioned are tied to substances such as alcohol, tobacco, stimulants, marijuana and opioids
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In the new study, researchers compared three types of shoppers in a group of 241 German adults: those with a pathological desire to shop, dubbed “compulsive buyers”; “risky” or impulsive shoppers, whose buying behavior was influenced by external factors like advertisements or life events; and people who engaged in intentional, planned shopping.
The study, published Feb. 16 in the journal Comprehensive Psychiatry, found that compulsive buyers scored higher on measures linked to addictive behaviors, including distress and the use of shopping for emotional gratification or compensation. They also reported lower self-esteem and higher levels of anxiety and depression compared with the other shoppers. Additionally, compulsive shoppers showed higher levels of impulsiveness and weaker performance on tasks that measure self-control.
Together, the findings suggest that compulsive shopping is more than just a bad habit and should be classified as a behavioral addiction, the study researchers argue. But making that case requires a definition of addiction.
Defining addiction
Not every intense habit qualifies as an addiction.
Dr. Nathan Carroll, a board-certified psychiatrist and author of “Internet Gaming Disorder: A Clinical Strategy Guide for Providers, Parents, and Players” (American Psychiatric Association Publishing, 2025), said addiction is defined by how much it disrupts a person’s life.
“When a behavior becomes so all-encompassing and so obsessive that you get functional impairment across multiple domains — socially, occupationally, educationally — that’s where it becomes an addiction,” Carroll told Live Science.
According to the DSM, a person can be diagnosed with gambling addiction if at least four of the following happen within one year:
● Frequent thoughts about gambling (such as reliving past gambling or planning future gambling)
● Need to gamble with increasing amounts to achieve the desired excitement
● Repeated unsuccessful efforts to control, cut back on or stop gambling
● Restlessness or irritability when trying to cut down or stop gambling
● Gambling when trying to escape from problems or negative mood or stress
● After losing an item of value by gambling, feeling the need to continue to get even (“chasing” one’s losses)
● Often gambling when feeling distressed
● After losing money gambling, often returning to get even
● Lying to hide the extent of gambling involvement
● Losing important opportunities, such as a job or school achievements or close relationships, due to gambling
● Relying on others to help with money problems caused by gambling
Mark Griffiths, a behavioral addiction researcher at Nottingham Trent University in the U.K., has studied a wide range of compulsive behaviors, including gambling, video gaming, internet use, exercise, work, and social media or smartphone use. He has also investigated excessive tanning, TV binge-watching, dance obsession, and even the obsessive viewing of eating videos, called mukbang.
Through four decades of research, Griffiths identified these six key criteria that help define addiction, which applies to both substance addictions and behavioral addictions:
- Salience: The behavior becomes the most important activity in a person’s life.
- Mood modification: The person uses the behavior to change how they feel.
- Tolerance: Increasing amounts of the activity are needed to achieve the same effect.
- Withdrawal: Stopping the behavior triggers negative psychological or physical symptoms.
- Conflict: The behavior harms relationships, work or education.
- Relapse: The person repeatedly returns to the behavior after trying to stop.
Griffiths noted that people need to meet all six of his criteria for their behavior to be classified as an addiction. According to his criteria, very few people would be classified as having a true shopping or gaming addiction, he told Live Science.
More often, people meet several criteria but not all of them, in which case the behavior may be better described as “problematic” rather than truly addictive.
Risks and benefits of classifying behaviors as addictions
Expanding the list of recognized behavioral addictions has both potential risks and benefits.
One concern is the possibility of pathologizing normal behavior. People who spend many hours working out, tabletop gaming or video gaming could be labeled as addicted when they are simply dedicated to their hobby, Carroll said. If diagnostic criteria for gaming addiction are too rigid, there is a risk of classifying professional gamers as addicts when they are not, he noted, and this can undermine the credibility of the diagnosis.
I do think the pendulum is swinging too far into the realm of obsession, and I think people are missing out on real-life experiences in pursuit of virtual experiences,
Dr. Nathan Carroll, board-certified psychiatrist
On the flip side, classifying more behaviors as addictions means having a useful framework for clinicians to distinguish normal behavior from pathological behavior, Carroll said.
These criteria would also help people recognize a problem they often can’t see. “The nature of addiction is that a lot of people don’t even see it in themselves when the addiction is occurring,” Carroll said.
Identifying an addiction is the first step toward treatment, which often involves addressing underlying conditions such as anxiety or depression, he said.
While Carroll is a self-confessed “huge fan of gaming,” he is in favor of recognizing behaviors like gaming disorder as addictions. “I do think the pendulum is swinging too far into the realm of obsession, and I think people are missing out on real-life experiences in pursuit of virtual experiences,” he said. “So I’m definitely in the camp where we should look at this as a behavioral addiction.”
Will the DSM-6 include new behavioral addictions?
The recognition of behavioral addictions has evolved gradually over time. When the DSM-3 was introduced in 1980, pathological gambling was listed as an impulse-control disorder, like kleptomania and pyromania. It wasn’t until the release of the DSM-5 in 2013 that it was renamed gambling disorder and reclassified as a behavioral addiction, based on brain imaging studies and neurochemical tests that showed gambling activates the reward system in a similar way that a drug does.
In DSM-6, gaming disorder will definitely be a fully recognized disorder, just like gambling disorder.
Mark Griffiths, behavioral addiction researcher
Internet gaming disorder also appears in the DSM-5 but as a condition that requires further research. The main reason it wasn’t classified as an addiction “was the lack of research backing it up,” Carroll said. “But I think we’ve produced quite a bit of research supporting that now.”
Griffiths agrees that the evidence base has grown substantially. “DSM-5 was published 13 years ago, and there’s been so much research now,” he said. “In DSM-6, gaming disorder will definitely be a fully recognized disorder, just like gambling disorder.”
Other diagnostic systems have already moved in that direction. The International Classification of Diseases 11th Revision, compiled by the World Health Organization and finalized in 2019, includes gambling disorder, gaming disorder and compulsive sexual behavior disorder.
Still, experts disagree about how quickly additional behavioral addictions will be recognized.
Aside from gaming addiction, Carroll believes there is strong evidence for shopping addiction to be included in the DSM. Beyond that, “there’s some good evidence for social media addiction and pornography addiction,” he said.
Griffiths takes a more cautious stance. While he believes addiction to social media, shopping, exercise, work and sex does occur, he argues that the current evidence base is still limited. “Most of the research is of relatively low quality,” he said. “We just haven’t got the quality research that we’ve got for gambling and gaming.”
Another issue is that it doesn’t make sense to classify something as a disorder without evidence that there is effective treatment, Griffiths said.
Without stronger epidemiological studies, biological research and treatment evidence, it’s not a good idea for other behavioral addictions to be included in the DSM, he said.
Perhaps, in 30 years, the situation will change, Griffiths said. But for now, he predicts that gaming disorder will be the only new behavioral addiction likely to be included in the next DSM.
