Evidence map›Paper›PMID 42110903›Full record

ArticleAlpha psychiatry2026

Phenotypic Clustering of Addictions Reveals Impulsivity Links to Internalizing Disorders: A Network Analysis.

Ardıl Bayram Şahin, Yusuf Huseyin Berrak, Duru Besen, Hilal Askin, Hale Yapici Eser

Abstract read
In one paragraph

Article in Alpha psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ardıl Bayram ŞahinGraduate School of Health Sciences, Koç University, 34010 Istanbul, Türkiye.ORCID https://orcid.org/0000-0003-4515-7530
Yusuf Huseyin BerrakSchool of Medicine, Koç University, 34010 Istanbul, Türkiye.ORCID https://orcid.org/0009-0006-6816-5081
Duru BesenSchool of Medicine, Koç University, 34010 Istanbul, Türkiye.ORCID https://orcid.org/0009-0004-2724-589X
Hilal AskinSchool of Medicine, Koç University, 34010 Istanbul, Türkiye.ORCID https://orcid.org/0009-0002-4933-1479
Hale Yapici EserResearch Center for Translational Medicine (KUTTAM), Koç University, 34010 Istanbul, Türkiye.ORCID https://orcid.org/0000-0003-0318-2770

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Substance-related and behavioral addictions frequently co-occur and are increasingly conceptualized as part of an interconnected psychopathological framework. Addictive behaviors are linked to internalizing symptoms, including depression, anxiety, and stress, through shared vulnerability. Although impulsivity, anhedonia, and stress-related processes have been proposed as transdiagnostic factors, their relative roles as central or bridging mechanisms remain unclear. This study aimed to clarify the network structure of multiple addictions by jointly modeling substance-related and behavioral addictions with multidimensional psychological features. Methods: A total of 169 university students completed standardized self-report measures assessing four substance-related addictions (alcohol, tobacco, cannabis, cocaine) and six behavioral addictions (gambling, shopping, gaming, eating, sexual activity, and work), alongside measures of impulsivity, anhedonia, depression, anxiety, stress, chronic stress, and childhood adversities. Three Extended Bayesian Information Criterion Graphical Least Absolute Shrinkage and Selection Operator (EBICglasso) network models were estimated: (i) an addiction-only network, (ii) an addictions-psychometric features network, and (iii) a focused network integrating selected addictions with affective symptoms, stress, and adversities. Centrality, bridge indices, and predictability were evaluated. Results: Substance-related and behavioral addictions formed a coherent and interconnected network, with alcohol (0.89), sexual activity (0.77), and cannabis (0.70) emerging as the most central hubs. Impulsivity and anxiety functioned as the primary bridge nodes linking addictive behaviors with internalizing symptomatology, with anxiety exhibiting the highest bridge strength (0.29), followed by impulsivity (0.20). The affective distress cluster, comprising depression, anxiety, and stress, demonstrated the strongest internal connectivity and the highest predictability (R Conclusion: This study models substance-related and behavioral addictions together with internalizing symptoms, impulsivity, anhedonia, and stress-related factors to examine how addictive behaviors are organized within an interconnected network. Alcohol, cannabis, and sexual activity showed relatively high connectivity, while impulsivity and anxiety were consistently positioned as bridge variables linking addictive behaviors with affective distress. These findings provide a descriptive transdiagnostic framework in which shared regulatory traits emerge as key organizing features of addiction comorbidity; however, their potential clinical relevance remains hypothesis-generating and requires validation in longitudinal and clinically diagnosed samples.

Indexed as

addictive behavioranhedoniaanxietydepressionimpulsivitynetwork analysisstress, psychologicalsubstance-related disorders

Identifiers

PMID42110903
PMCPMC13156064

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.