The neurobehavioral pathway from negative affect to habit-like escape in internet gaming disorder: A narrative review

Gaming that begins as a response to distress can become persistent even when its emotional benefits change. Explaining this persistence requires distinguishing the conditions that establish gaming from the processes that maintain it. This narrative review integrates motivational, learning, and corticostriatal evidence to specify a negative-affect pathway in internet gaming disorder. Its central proposition is that repeated, context-specific relief learning can establish cue-triggered gaming whose expression becomes progressively less dependent on current distress. Whether that persistence remains sensitive to the expected gaming outcome determines its interpretation as goal-directed relief seeking or habit-like control. Three interacting processes organize the account: relief valuation, cue-guided action selection, and flexible control. Gaming-motive syntheses establish the relevance of escape motives, whereas ambulatory, outcome-devaluation, and longitudinal findings distinguish motive endorsement from momentary triggers and cue influence from outcome insensitivity. Relative to I-PACE and C-DOG, the framework specifies the relationship between affective learning history, current affect, and outcome sensitivity, yielding contrasting predictions for continued relief valuation, learned cue control, and generalized reward seeking. A coordinated research agenda combines event-based assessment, experimental manipulation of relief contingencies and outcome value, and repeated behavioral and neural measurement. The resulting account explains how similar patterns of persistent gaming can arise from different control processes and identifies the comparisons needed to establish a transition from relief seeking to habit-like escape.