Parallel addictions: understanding the psychological and neurobehavioral damage of gaming and alcohol use in adolescents and young adults

Abstract

Introduction Adolescence and young adulthood are critical neurodevelopmental periods characterized by increased vulnerability to addictive behaviors due to ongoing maturation of reward-processing and executive-control systems. Gaming Disorder (GD) and Alcohol Use Disorder (AUD) have emerged as significant behavioral and public mental health concerns among youth populations. To review and synthesize the psychological, cognitive, psychosocial and neurobiological correlates of GD and AUD in adolescents and young adults and to consider their common and disorder-specific vulnerabilities. Methods A narrative review was carried out following principles guided by SANRA. A structured literature search was conducted in PubMed, Scopus, PsycINFO and Google Scholar for peer-reviewed studies published between 2010 and 2025. Thirty-three studies fulfilling the inclusion criteria were thematically synthesized across neurobiological, emotional, cognitive and psychosocial domains. Results Gaming Disorder (GD) and Alcohol Use Disorder (AUD) showed significant overlap in emotional dysregulation, impulsivity, executive dysfunction, and reward-processing abnormalities. Neuroimaging studies showed convergent alterations in dopaminergic reward pathways and prefrontal-limbic circuitry involved in craving and impaired inhibitory control. However, GD was more associated with online peer attachment and immersive digital engagement, whereas AUD was more associated with physiological dependence and neurotoxic effects. Both disorders were associated with impaired academic functioning, maladaptive coping and psychosocial dysfunction during adolescence. Discussion Gaming Disorder (GD) and Alcohol Use Disorder (AUD) are distinct clinical but neurobehaviorally and developmentally vulnerable. Integrated prevention and intervention approaches targeting common transdiagnostic mechanisms may improve early identification and mental health outcomes among adolescents and young adults.