How to pin a compulsive behavior down: A systematic review and conceptual synthesis of compulsivity-sensitive items in measures of behavioral addiction Muela Aguilera, Ismael Navas, Juan F. Ventura-Lucena, José María Perales López, José César Compulsivity Habits Craving Behavioral addiction Self report Operational definition Acknowledgements We would like to thank the Spanish the Spanish National Research Agency (Agencia Estatal de Investigación), Ministry of Science and Innovation (Ministerio de Ciencia e Innovación), for funding the project to which this study belongs. We would like to thank Sergio Fernández- Artamendi (Loyola University, Seville, Spain), and Damien Brevers and Pierre Maurage (Université Catholique de Louvain, Louvain La Neuve, Belgium) for their assistance as external experts for inter-judges agreement assessment, and for identification of delimitation problems. We would also like to thank Sumara Suzzette Prince Davidson for her assistance in translating Spanish items into English for external evaluation. Funding The roles of the first, second, and third authors in this publication are part of a R&D project (proyecto I + D + I), funded by the Spanish Research Agency (Agencia Española de Investigación), Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación) (MCIN/ AEI/10.13039/501100011033/), with reference PID2020-116535 GBI00, and by a predoctoral fellowship (PRE2018-085150) from the Spanish Ministry of Science and Innovation to IM. Experimental models identify the transition from choice to compulsivity as the main mechanism underlying addiction. In behavioral addictions research, however, the adjective compulsive is used to describe virtually any kind of excessive or dysregulated behavior, which hinders the connection between experimental and clinical models. In this systematic review, we adopted a preliminary definition of compulsive behavior based on previous theoretical work. Subsequently, a systematic review following PRISMA guidelines was conducted (a) to identify the validated instruments, currently used in behavioral addictions research, that include items that are sensitive (intendedly or not) to compulsivity, and (b) to categorize those items into differentiable operationalizations of compulsivity. Six operationalizations of compulsivity emerged from item content analysis: 1. Automatic or habitual behavior occurring in absence of conscious instrumental goals; 2. Behavior insensitive to negative consequences despite conscious awareness of them; 3. Overwhelming urge or desire that impels the individual to initiate the activity and jeopardizes control attempts; 4. Bingeing, or inability to stop or interrupt the activity once initiated, resulting in an episode substantially longer or more intense than intended; 5. Attentional capture and cognitive hijacking; and 6. Inflexible rules, stereotyped behaviors, and rituals related to task completion or execution. Subsequently, a list of 15 representative items per operationalization was elaborated for independent assessment and identification of delimitation problems. A high degree of agreement was reached in assessing them as instantiating compulsivity, as well as in their assignment to the corresponding categories. However, many of them were also considered overinclusive, i.e., uncapable of distinguishing compulsivity from valuebased momentary choice. To increase their discriminative value, items in future compulsivity scales should be refined to explicitly mention disconnection between behavior and declarative goals. Further research on factorial structure of a pool of items derived from these operational definitions is warranted. Such a factorial structure could be used as an intermediate link between specific behavioral items and explanatory psychobiological, learning, and cognitive mechanisms. 2022-07-21T09:02:17Z 2022-07-21T09:02:17Z 2022-06-13 journal article I. Muela et al. How to pin a compulsive behavior down: A systematic review and conceptual synthesis of compulsivity-sensitive items in measures of behavioral addiction. Addictive Behaviors 134 (2022) 107410 [https://doi.org/10.1016/j.addbeh.2022.107410] http://hdl.handle.net/10481/76320 10.1016/j.addbeh.2022.107410 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional Elsevier