While internet-based behaviors are commonly part of everyday life, some of them have the potential to become addictive if they are carried out in an excessive and uncontrolled way. Those behaviors include:
- Gaming
- Gambling
- Buying-shopping
- Pornography use
- Social network use
Theory and research point to a familiar set of processes that impede control: situational and/or application-specific triggers, cue reactivity, and craving, challenges with self-control in the moment, and reinforcement through short-term relief or (experienced) gratification. While research is growing, much of the evidence is based on cross-sectional studies in laboratory settings with limited ecological validity.
Ambulatory assessment offers insight into phenomenology and underlying mechanisms in daily life. As an umbrella term (e.g., ecological momentary assessment, experience sampling, daily diaries), it:
- focuses on individuals’ behavioral, physiological, and affective states and processes
- collects data in natural environments
- uses multiple assessments of current or very recent states and events (Trull & Ebner-Priemer, 2013)
In our preregistered systematic review (search period: 2000–2025; PubMed and Web of Science), we summarize 48 ambulatory assessment studies in the field of behavioral addictions by using a theoretical framework to categorize the empirical results and investigated constructs. Thereby, we discuss methodological approaches for the investigation of underlying psychological mechanisms of behavioral addictions. We further formulate recommendations on study designs based on the current results and existing guidelines.
What stood out
- Real-life patterns: Across studies, momentary cues, craving, and short-term reinforcement processes emerge as key mechanisms
- Uneven coverage: Some behaviors are well-studied with ambulatory methods (e.g., gambling); others remain under-examined despite clinical relevance (e.g., gaming).
- Simple tools, heterogenous designs prevail: Brief self-reports are dominant; assessment schedules and outcomes vary widely, which makes findings hard to compare and synthesize.
- Research gaps: Real-life assessments of key mechanisms in addictive behaviors such as inhibitory control and seemingly habitual behavior are rare, and reporting/analysis practices are inconsistent
Why this matters for clinicians
- Ambulatory assessment data support clinical work by providing real-time picture of patients’ symptoms and experiences and may contribute to more accurate diagnoses
- Ambulatory assessment data may improve the understanding of potentially fluctuating symptoms and the influence of environmental and situational factors on the occurrence and/or improvement of symptoms
- Ambulatory assessment data may inform personalized treatment plans and help to adjust interventions
- Ambulatory assessment data may enhance ecological validity by identifying risky factors in the natural environment where addictive behaviors actually occur.
- Ambulatory assessment data may improve the understanding of similar and distinctive features of addictive behaviors: While some mechanisms, such as craving, emerge as underlying mechanisms across behavior types, other mechanisms may be of varying relevance in daily lives (e.g., inhibitory control)
A snapshot of our recommendations to increase comparability
- Use consistent definitions and standardized measures
- Differentiate between dynamic state variables (e.g., self-control) and trait-like variables (e.g., symptom of impaired control) in the assessment
- Combine self-report with objective indicators whenever feasible
Key takeaways: Real-time evidence is enhancing our knowledge about behavioral addictions. Our review highlights the current state of research—and offers practical implications regarding more comparable, clinically beneficial methods. For details on the studies, gaps, and recommendations, see the full article.
DISCUSSION QUESTIONS
- What core set of ambulatory assessment measures and behavior outcomes should be harmonized to enable cross-study comparisons and meta-analyses?
- Does merely taking part in ambulatory assessment studies influence participants’ behavior?
- Which passive sensing signals (e.g., device/app logs, platform-level data, wearables) are both practically feasible and clinically meaningful across different behavioral addictions?
- How can we best balance measurement depth against participant burden to sustain high compliance in real-world settings?
- How can inhibitory control and seemingly habitual behavior be validly and reliably captured within real-life settings?
ABOUT THE AUTHORS
Anna Knorr: Anna Knorr studied Clinical Psychology and is currently working on her PhD in the field of behavioral addictions. Her research expertise is in ambulatory assessments with a focus on self-control mechanisms in individuals with problematic pornography use and gaming. Anna Knorr can be contacted via anna.knorr@cognition-ude.de.
Elisa Wegmann, Dr is a Postdoctoral Research Fellow at the Department General Psychology: Cognition at the University of Duisburg-Essen. Her research focuses on specific predisposing variables, and affective and cognitive mechanisms in different types of addictive behaviors, particularly problematic social network use.
Astrid Müller, Prof. Dr. Dr. Astrid Müller (MD, PhD) is a licensed psychotherapist and Associate Professor at the Department of Psychosomatic Medicine and Psychotherapy at Hannover Medical School. Her clinical and scientific work focuses on psychosocial correlates, psychological mechanisms and psychotherapy of behavioral addictions, particularly compulsive buying, and addiction-like eating behavior in obesity.
Matthias Brand, Prof. Dr. Matthias Brand is a Full Professor of General Psychology: Cognition at the University of Duisburg-Essen and Director of CeBAR and the Erwin L. Hahn Institute. His research examines the neurobiological and psychological mechanisms of behavioral addictions, with a focus on Internet-use disorders such as gaming, social networking, pornography use, and online shopping. He is speaker of the DFG Research Unit FOR2974 (ACSID) and has published over 300 peer-reviewed articles.
Stephanie Antons, Prof. Dr. Stephanie Antons is a Full Professor of General Psychology at the University of Siegen. She is particularly interested in affective and cognitive mechanisms involved in the development and maintenance of behavioral addictions, using mixed methods such as neuroimaging, ecological momentary assessment, and machine learning. With these approaches, she aims to identify mechanisms that can explain and predict moments of impaired control in behavioral addictions.
REFERENCES CITED
Knorr, A., Wegmann, E., Müller, A., Brand, M., & Antons, S. (in press). Ambulatory Assessment in the context of behavioral addictions: A systematic review. Clinical Psychology: Science and Practice.