Understanding loss of control over behavior requires moving beyond diagnostic categories toward a process-based and integrative perspective. This framework proposes that dysregulated behaviors emerge from interactions between multiple regulatory systems, shaped by contextual and social factors.
At its core, the model considers four interacting systems: cognitive, emotional, interoceptive, and metacognitive processes. Rather than operating independently, these systems dynamically interact to regulate behavior. When this balance is disrupted, a state of dysregulation emerges.
In this context, phenomena such as craving are conceptualized as manifestations of this dysregulation, reflecting how altered internal states translate into urges and observable behaviors. Craving is therefore not treated as an isolated mechanism, but as an expression of underlying regulatory dysfunction.
Contextual and social factors, including social pain (e.g., rejection, exclusion, social pressure), are considered key modulators within this framework. They can act as triggers or amplifiers of dysregulation, increasing vulnerability to maladaptive behaviors.
Ultimately, this process can lead to a loss of control over behavior, a central feature across a range of conditions. This framework provides a transdiagnostic perspective to understand such loss of control in eating disorders, addictions, and related conditions. Importantly, these outcomes may further reinforce social vulnerability, creating self-sustaining cycles of dysregulation.
Selected References
Flaudias, V., Heeren, A., Brousse, G. & Maurage, P. (2019) Towards a triadic approach to craving in addictive disorders: The metacognitive hub model. Harvard Review of Psychiatry, 27(5):326-331 (IF=3.264, Q1 “Psychiatry and mental health) https://doi.org/10.1097/hrp.0000000000000225
Cornil, A., Lakritz, C., Iceta, S., & Flaudias, V. (2025). Craving in Eating Disorders: Mapping the Concept Through a Systematic Review. Neuroscience & Biobehavioral Reviews, 106515. (IF =7.9, Q1 « Behavioral Neuroscience » « Cognitive Neurosciences » « Neuropsychology and Physiological Psychology) https://doi.org/10.1016/j.neubiorev.2025.106515
Flaudias, V., Gonthier, C., Cornil, A., Seneque, M., Lakritz, C., Iceta, S. & Guillaume, S. (2026). Toward a triadic approach in eating disorders: Investigating the contribution of the reflexive, affective and interoceptive systems in a clinical data cohort. Journal of Eating Disorders. (IF =4.5, Q1 « Behavioral Neuroscience » « Psychiatry and Mental Health » « Nutrition and dietetics ») https://doi.org/10.1186/s40337-026-01602-0