The Interrelation Between Emotional Impulsivity, Craving, and Symptoms Severity in Behavioral Addictions and Related Conditions: a Theory-Driven Systematic Review

Abstract Purpose of Review Here, we systematically review all available evidence on the triadic relationship between positive and negative urgency, craving, and severity of symptoms of candidate behavioral addictions. Recent Findings Current theoretical models attribute a central importance to craving in the chronification and prognosis of behavioral addictions and other problematic non-substance-related behavioral patterns. Craving, in turn, has been convincingly shown to be an affect-laden state, and its control can be conceptualized as partially resulting from emotion regulation mechanisms. However, some gaps remain: first, there is no consensus on the predominantly appetitive or aversive nature of craving; and, second, although positive and negative urgency have been proposed as proxies to incidental emotion regulation mechanisms, their direct or indirect role in craving regulation and severity of problematic behaviors is still poorly known. Summary According to our results, craving emerges as a central construct, partially resulting from emotion dysregulation as assessed by urgency. The preponderance of positive urgency shown by most studies in this review also reinforces the view of positive emotions as a ‘trojan horse’ in addictive processes. Negative urgency, in turn, seems to be a complication factor that could underlie gambling addiction and other related mental health conditions. Most studies, however, are about gambling behavior, with the few studies in other domains precluding firm conclusions about the differences or similarities between them.