Examination of loss of control as a potential transdiagnostic risk factor linking behavioral addictions with other addiction-related disorders in early adulthood

A core feature of behavioral addictions (e.g., internet gaming, social media use), substance use, and eating disorders is loss of control (LOC), or difficulty stopping a rewarding behavior once initiated. Similarities in LOC across disorders suggest that there could exist a general propensity towards losing control over rewarding behaviors. However, studies that integrate data on LOC across multiple behaviors are scarce. We examined the co-occurrence of LOC over internet gaming, social media use, alcohol use, cannabis use, and eating in young adulthood, sex differences in LOC, and the role of impulsivity in these associations. Participants (N=1396; 55.9% female; 44.1% male; 20.72-28.29 years) were drawn from a prospective study and self-reported their LOC over internet gaming, social media, alcohol, cannabis, and eating and their impulsivity. LOC over internet gaming and social media were endorsed as, or more frequently than, other behaviors, like alcohol and cannabis use. Females reported more LOC over social media and eating, but less LOC over internet gaming, alcohol, and cannabis relative to males. Analyses showed that, even after controlling for impulsivity, LOC over eating predicted a twofold increase in risk for LOC over social media and alcohol. LOC over cannabis predicted a twofold increase in risk for LOC over internet gaming and alcohol. Associations were not moderated by sex. Young adults who endorse one type of LOC show greater risk for additional types of LOC irrespective of impulsivity. Research is needed to understand the potentially common role of LOC in behavioral addictions, substance use, and eating disorders.