The experience of gratification and compensation in addictive behaviors: How can these experiences be measured systematically within and across disorders due to addictive behaviors?

BACKGROUND

Beyond gaming disorder and gambling disorder, pornography-use disorder, buying-shopping disorder, and social-networksuse disorders are discussed as further disorders due to addictive behaviors. For addictive behaviors, it is assumed that the experience of gratification and the experience of compensation due to the specific behavior represent reinforcing processes involved in the development and maintenance of the problematic behaviors. We aimed to develop two questionnaires that capture the experienced gratification and experienced compensation while using online activities. We additionally assume significant relationships with further addiction-related constructs such as symptom severity, use expectancies, and craving experiences.

METHODS

We conducted three studies for the development of the "Experience of Gratification Scale" (EGS) and the "Experience of Compensation Scale" (ECS). In each study, participants answered the questionnaires modified for their preferred online activity (gaming, gambling, buying-shopping, social-networks use, pornography use). Additional questionnaires were used, assessing further addiction-related constructs.

RESULTS

The results of the gradual approach by using exploratory and confirmatory factor analyses indicated for both scales a two-factor solution resulting in "gratification of needs" and "experience of pleasure" for the EGS, and "compensation of needs" and "experience of relief from negative feelings" for the ECS. The factors were significantly correlated with each other as well as with craving experiences, use expectancies, and symptom severity. Moreover, we found significant differences in the experienced gratification and experienced compensation for specific online behaviors.

CONCLUSION

The theoretically plausible specific factors for experienced gratification and experienced compensation could be identified and were related to constructs considered important in addictive online behaviors. Further studies should investigate the relevance of these constructs for different types of addictive behaviors, but also within the addiction process addressing specific needs and motives as well as further positive and negative reinforcement mechanisms.

Online gaming addiction in youth: Some comments on Rosendo-Rios et al. (2022)

A recent systematic review examining online gaming addiction among children and young adults was published in Addictive Behaviors (i.e., Rosendo-Rios, Trott & Shukla, 2022). However, dozens of papers were missing from the review. One of the reasons why so many studies were not in the review is likely to be because of the search terms used. None of the search terms included the words 'adolescent', 'adolescence', 'emerging adults', 'excessive gaming', 'gaming disorder', 'video game addiction' or 'problematic gaming'. Moreover, studies were also included in the review if the mean age of the total sample was 25 years or below. This meant that some studies in the review included some participants who were not children, adolescents or emerging adults. It also meant that many studies were not included that had mean ages below the age of 26 years because they were not picked up by the search strategy. Given the high number of studies that were not included in the review, readers should view this systematic review as 'suggestive' of research in the area of problematic gaming in youth rather than 'definitive'.

Validation of the metacognitions about online gaming scale (MOGS) among Chinese gamers

With the largest online gamer population worldwide and a heightened rate of Internet Gaming Disorder (IGD), China has a long-lasting need to identify salient correlates of IGD and provide corresponding assessment tools to support cost-effective IGD screening and interventions. To respond to such a need, the present study aimed to validate the Metacognitions about Online Gaming Scale (MOGS) among Chinese gamers to provide an additional tool for promoting studies investigating metacognition, a promising and newly emerged correlate of IGD, in China. To evaluate the psychometric properties of MOGS, we collected data from 1340 Chinese university students with gaming experiences (59.3% female, M_age = 19.84 years), in which 262 of them also participated in the one-month retest. Our results indicated that the Chinese version of MOGS has a two-factor structure and satisfactory reliabilities (α = 0.90 and 0.92, ICC = 0.60 and 0.64, AVE = 0.56 and 0.70, ρ_c = 0.88 and 0.92). Moreover, MOGS's convergent validity was evidenced by the expected, positive associations with generic metacognitions, stress, and IGD tendency (r (1338) = 0.29-0.55, p < 0.001) as well as significant MOGS differences between probable IGD and non-IGD gamers (p < 0.001). A 6-item, short-form MOGS, which displayed equivalent psychometric soundness as its full-scale counterpart, was also developed. As the first study to validate MOGS among Chinese gamers, the present study attested to the readiness of this measure in facilitating further studies of gaming-specific metacognitions for early identification of and tailored interventions for high-risk gamers in China.

Problematic gaming and quality of life in online competitive videogame players: Identification of motivational profiles

BACKGROUND

Online competitive practice of video games has recently known a significant worldwide expansion. However, this practice can be associated to problematic use and deterioration of quality of life depending on multiple determinants, among which motivation is central. The purpose of this study was to identify motivational clusters and to compare them regarding quality of life, problematic use of video game, and personality traits.

METHODS

Participants (N = 256) in this cross-sectional study were recruited through specialized websites to complete self-reported questionnaires assessing motivation to play online (MOGQ), personality (BFI-Fr), quality of life (WHOQOL-BREF), and problematic gaming (IGD-Scale). A hierarchical clustering analysis and intergroup comparative analyses were conducted.

FINDINGS

Three motivational clusters were identified ("recreational", "competitive" and "escapers"). "Competitive" and "escapers" players reported higher IGD scores than the "recreational" players (p <.001). However, "escapers" players had lower psychological health scores (p <.001), were more neurotic (p <.001), and less extroverted (p <.001) than the others. Based on IGD scores, "competitive" and "escapers" players were considered as problematic albeit only "escapers" exhibited a functional impairment. Therefore, engaged and problematic players cannot be differentiated with IGD scores.

DISCUSSION

IGD scores were insufficient to differentiate between players at risk of evolution toward pathological states (i.e., "escapers" players) and those whose strong engagement is not detrimental to their quality of life (i.e., "competitive" players). Consequently, considering both psychological health and motivation is necessary to assess the problematic nature of competitive videogame practice. Better definitions and assessment tools are essential in order to avoid over-diagnosis of non-pathological gaming behavior.

Epidemiology of gaming disorder and its effect on anxiety and insomnia in Chinese ethnic minority adolescents

BACKGROUND

The growing popularity and frequency of online game use have resulted in a large number of studies reporting various mental problems associated with game abuse in adolescents. In this article, we examined the prevalence of gaming disorder (GD) and explored the associations of GD with anxiety and insomnia symptoms in minority youth in China.

METHODS

A total of 1494 students completed the Problematic Online Gaming Questionnaire Short-Form (POGQ-SF), the Generalized Anxiety Disorder 7-item questionnaire (GAD-7), and Athens Insomnia Scale (AIS). Chi-square and binary logistic regression analyses were used to explore the associations between gaming disorder and anxiety/insomnia.

RESULTS

A total of 356 (23.83%) respondents reported that they had gaming disorder. Chi-square analysis showed that gender, grade, marital status of parents and exercise situation were significantly associated with GD. Binary logistic regression analysis showed that those who had GD were at significantly higher risk for anxiety and insomnia than those without GD.

CONCLUSION

We found a high incidence of GD and a positive association among anxiety, insomnia and GD. Thus, special attention should be paid to those who have suffered from GD. It is worth addressing the adverse effects of GD on anxiety and insomnia.

Prevalence of gaming disorder: A meta-analysis

BACKGROUND

Gaming disorder (GD) has been listed in the International Classification of Diseases 11th Revision. Studies on GD prevalence have been highly heterogeneous, and there are significant gaps in prevalence estimates. Few studies have examined what methodological and demographic factors could explain this phenomenon. Therefore, this meta-analytic study quantifies globally reported GD prevalence rates and explores their various moderating variables.

METHODS

Prevalence estimates were extracted from 61 studies conducted before December 3, 2020, which included 227,665 participants across 29 countries. Subgroup and moderator analyses were used to investigate the potential causes of heterogeneity, including region, sample size, year of data collection, age group, study design, sampling method, survey format, sample type, risk of bias, terminology, assessment tool, and male proportion.

RESULTS

The overall pooled prevalence of GD was 3.3% (95% confidence interval: 2.6-4.0) (8.5% in males and 3.5% in females). By selecting only 28 representative sample studies, the prevalence estimate was reduced to 2.4% (95% CI 1.7-3.2), and the adjusted prevalence estimate using the trim-and-fill method was 1.4% (95% CI 0.9-1.9). High heterogeneity in GD prevalence rates was influenced by various moderators, such as participant variables (e.g., region, sample size, and age) and study methodology (e.g., study design, sampling method, sample type, terminology, and instrument). The moderator analyses revealed that the sample size, mean age, and study quality were negatively associated with GD prevalence.

CONCLUSIONS

This study confirms that GD prevalence studies were highly heterogeneous based on participant demographics and research methodologies. Various confounding variables, such as sampling methods, sample types, assessment tools, age, region, and cultural factors have significantly influenced the GD prevalence rates. Prevalence estimates are likely to vary depending on study quality. Further epidemiological studies should be conducted using rigorous methodological standards to more accurately estimate GD prevalence.

Association between relationship adaptation and Internet gaming disorder among first-year secondary school students in China: Mediation effects via social support and loneliness

Adolescents encounter numerous challenges and need to restructure their social relationships when they enter secondary schools. Relationship adaptation is critical and failure in adaptation may be associated with Internet gaming disorder (IGD). This novel study investigated the association between relationship adaptation and IGD and related mediation mechanisms via social support and loneliness among first-year secondary school students in Shanghai and Xi'an, China in 2018. Of 2573 participants, the prevalence of IGD was 13.1%. Relationship adaptation, social support, and loneliness were all significantly associated with IGD. The association between relationship adaptation and IGD was fully mediated by three indirect paths, including relationship adaptation → social support → IGD (effect size = 35.5%), relationship adaptation → loneliness → IGD (effect size = 34.3%), and relationship adaptation → social support → loneliness → IGD (effect size = 6.1%). In conclusion, the observed high prevalence of IGD among first-year secondary school students in China was associated with poor relationship adaptation. The full mediation effects via social support and loneliness suggest that modification of these two psychosocial attributes may effectively reduce the harmful impacts of poor relationship adaptation on adolescent IGD. Future longitudinal studies are warranted to confirm the findings.

Psychometric evaluation of the Russian version of the Gaming Disorder Scale for Adolescents

Problematic gaming has become an emerging global health issue. Formal recognition of gaming disorder in the ICD-11 is a new opportunity for the discipline to conduct further investigation concerning the psychological consequences of problematic gaming. The present study investigated the psychometric properties and construct structure of the recently developed Gaming Disorder for Scale for Adolescents (GADIS-A), a multi-dimensional instrument that screens for gaming disorder symptoms, among Russian adolescent gamers. The sample comprised 933 adolescent gamers (547 boys and 386 girls) recruited via a web-based platform, using a multistage sampling method. Analysis showed the GADIS-A had very good internal consistency (Cronbach's alpha coefficient = .891; Composite reliability = .89) and adequate test-retest reliability after two weeks (intraclass coefficient  =0.68 with 95% CI [0.61, 0.77]. Exploratory structural equation modeling (ESEM) showed the data fitted well. Measurement invariance testing indicated the GADIS-A was invariant by gender and gaming medium (online vs. offline). As for criterion-related validity, high scores on the GADIS-A positively correlated with scales assessing depression, anxiety, impulsivity, and difficulties in emotion regulation, and negatively correlated with social connectedness and life satisfaction. Using latent profile analysis, four groups of gamers were identified, and problematic gaming was associated with greater mental health problems. The findings indicated that psychological comorbidity (e.g., depression and anxiety) was more prevalent among gamers with higher risk of GD. The findings indicate that GADIS-A is a reliable and valid instrument to assess the symptoms and severity of gaming disorder among Russian adolescents.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02575-w.

Polysubstance Use Is Positively Associated with Gaming Disorder Symptom Severity: A Latent Class Analytical Study

INTRODUCTION

The link between gaming disorder (GD) and substance use amongst adolescents is not clear. Some studies reported positive associations, whereas others suggested that alcohol and illicit drug use are not related to GD severity.

OBJECTIVES

The present study aimed to identify empirically based latent classes of alcohol and illicit drug use amongst adolescents and explore their associations with GD symptom severity and whether endorsement of specific criteria of GD is linked to the membership of latent classes of alcohol and illicit drug use.

METHODS

Data of the national sample of Hungarian adolescents from the Health Behaviour in School-aged Children survey (N = 2,768; females: 52.08%; mean age: 16.73 years) were analysed. Measures for frequency of alcohol and illicit drug use, gaming, GD symptom severity, and life satisfaction were included in the analyses.

RESULTS

Latent class analysis discriminated 4 subgroups of alcohol and illicit drug use: polysubstance users, high-risk alcohol users, moderate alcohol users, and infrequent substance users. Polysubstance users presented significantly higher levels of GD symptom severity and higher odds for endorsement of criteria of "giving up other activities" and "negative consequences."

CONCLUSIONS

Positive associations were shown between higher GD severity and the polysubstance using class. The roles of criteria of "giving up other activities" and "negative consequences" were highlighted in more severe substance use patterns. However, GD severity and criteria did not differ as a function of the level of alcohol use. These findings may imply common roots of GD and illicit drug use in adolescents.

Is the proposed distinction of gaming disorder into a predominantly online vs. offline form meaningful? Empirical evidence from a large German speaking gamer sample

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Disordered gaming is distinguished by predominantly online, offline, and unspecific gaming.

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Online gamers showed the highest tendencies towards disordered gaming.

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Gaming via desktop computers was linked with the highest disordered gaming levels.

In the eleventh revision of the International Classification of Diseases (ICD-11), Gaming Disorder (GD) is distinguished between disordered gaming occurring predominantly online, offline, and unspecified. Currently, no study has investigated whether such a distinction is meaningful in diagnosing disordered gaming. Therefore, a large group of gamers with varied tendencies towards disordered gaming was recruited to examine this issue. A large sample (N = 2,768) was recruited and data were collected on disordered gaming, along with information on their preferred gaming mode and device used to play. The present study shows that the distinction between online and offline gaming mode proposed by the WHO is meaningful because online gamers presented with the highest disordered gaming scores followed by mixed gamers (those stating to equally prefer online and offline gaming), and offline gamers. Finally, it was also observed that the type of device for gaming used associated with disordered gaming levels. Specifically, those reporting mostly to use their desktop computer for gaming showed the highest disordered gaming scores. The present study lends empirical support for the consideration of both gaming mode and gaming device in the study of disordered gaming.

Factors related to the dual condition of gambling and gaming disorders: A path analysis model

BACKGROUND AND AIMS

Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder.

METHODS

The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits.

RESULTS

The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness.

CONCLUSIONS

The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.

[Gambling and Internet habits in a French population with addictive disorders seeking treatment: a multicentric study]

BACKGROUND

Transversal grouping of addictions under the heading "Substance related and addictive disorders" in the DSM-5 has led to a common policy on addictions and the promotion of addiction services covering all types of addictions, including behavioral addictions.

MATERIAL AND METHODS

The main objective of this study was to describe the prevalence of problem gambling in a population of patients seeking treatment in addictive disorders center. Secondary objectives were: to describe the use of Internet and the prevalence of gaming disorder, sexual addiction and compulsive buying online ; to describe a population of patients consulting in addictive disorders center; to explore associated factors related to problem gambling. A self-questionnaire was built, evaluating the socio-demographic elements, the addiction pathway, problem gambling and Internet use with a focus on video game disorder, sexual addiction and compulsive buying. It was offered to consultants from five addictology centers in Brittany.

RESULTS

252 patients seeking treatment for addictive disorders were included. Problem gambling was present in 9.9 % of patients. Problem gamblers were more likely to have been asked about their gambling by the addictology team than other patients. The rate of identification of gambling habits, whether in addiction or outside, was generally low. Internet use was 83 %. The prevalence of other online behavioral addictions was low.

DISCUSSION AND CONCLUSION

The prevalence of problem gambling is almost 4 times higher among addictology consultants, compared to the general population, probably related to addictive comorbidities. The identification of gambling habits concerned a small proportion of the patients included, whether in specialized care or outside. There is significant room for improvement in the identification of problem gambling, in addictology and beyond. It is important to question gambling habits for any reason for addiction consultation and to repeat this identification over time. As the Internet is widely used by addictology consultants, it can represent a key element in care, both in the identification of behavioral addictions and in follow-up.

Problem Gambling and Problem Gaming in Elite Athletes: a Literature Review

Researchers have raised concerns about mental health in elite athletes, including problem gambling, where research hitherto is scarce. While gambling has been assessed in the younger student-athlete population, neither gambling nor the recently recognized behavioral addiction of gaming disorder has been sufficiently addressed in the elite athlete population. The present systematic literature review aimed to summarize research knowledge on the prevalence and correlates of problem gambling and problem gaming in elite athletes. Research papers were searched systematically using the Scopus, PsycINFO, and PubMed/MEDLINE databases and evaluated following a PRISMA paradigm. For the elite athlete population, eight reports on problem gambling and one report on problem gaming were found. While at least five papers indicated an increased risk of problem gambling in elite athletes compared to the general population, one study from Australia indicated the opposite. Problem gambling was generally more common in male athletes. Knowledge of problem gaming prevalence is thus far limited. It is concluded that increased research in problem gambling and problem gaming in elite athletes is warranted.

Profile of Treatment-Seeking Gaming Disorder Patients: A Network Perspective

The increasing presence of gaming disorder in recent years has led to major efforts to identify the specific predictors that have a high impact on the profile of people seeking treatment for this mental condition. The purpose of this study was to explore the network structure of the correlates of gaming disorder considering sociodemographic features and other clinical symptoms. Network analysis was applied to a sample of patients who met clinical criteria for gaming disorder (n = 117, of ages ranging from 15 to 70 yrs-old). Variables considered in the network included sex, age, socioeconomic position, global emotional distress, age of onset and duration of the gaming disorder, personality traits and the presence of other addictive behaviors (tobacco, alcohol and behavioral addictions). The central nodes in the network were global psychological distress, chronological age, and age of onset of gaming related problems. Linkage analysis also identified psychopathological status and age as the variables with the most valuable information in the model. The poorest relevance in the analysis was for the duration of gaming problems and socioeconomic levels. Modularity analysis grouped the nodes within four clusters. Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat gaming disorder related problems.

Associations between gaming disorder, parent-child relationship, parental supervision, and discipline styles: Findings from a school-based survey during the COVID-19 pandemic in Vietnam

BACKGROUND AND AIMS

Vietnam implemented numerous measures to reduce the transmission of COVID-19 among school students, including study-at-home/self-quarantine. During the study-at-home period, adolescents may engage in more video gaming than usual, potentially contributing to gaming disorder. However, the regionally-representative prevalence of gaming disorder and its association with parenting practice and discipline practice have not been described. We assessed the prevalence of gaming disorder among Vietnamese adolescents during the initial 6 months of the COVID-19 pandemic and the associations between gaming disorder and parenting practice and discipline practice.

METHODS

We conducted a school-based, self-administered cross-sectional survey of 2,084 students in Hanoi, Vietnam (response rate = 97.1%). The survey included standardized instruments translated from English to Vietnamese. We performed multilevel logistic regressions to assess the associations between parenting practice, discipline practice, and gaming disorder.

RESULTS

The prevalence of gaming disorder among the respondents was 11.6%. Healthy parent-child relationship was protective against gaming disorder (Adj OR = 0.36; 95% CI = 0.21, 0.62). Non-supervision, non-discipline, violent discipline were positively associated with gaming disorder.

DISCUSSION AND CONCLUSIONS

We found associations between gaming disorder and parent-child relationship, parental supervision, and parental discipline. Future interventional studies should consider assessing the effect of fostering healthy parent-child relationships and appropriate discipline on the occurrence or prognosis of gaming disorders.

Extended classifier system with continuous real-coded variables for feature extraction of instantaneous pulse-rate variability and respiration of individuals with gaming disorder

Background

Individuals with gaming disorder (GD) exhibit autonomic nervous system responses that indicate dysfunctional emotion regulation. Pulse rate variability (PRV) is a valuable biomarker for investigating the autonomic function of patients with mental disorders. Because individuals with GD dynamically regulate emotions during gaming, the PRV response relating to GD is not well understood. To investigate the dynamic PRV responses of individuals with GD, this study proposed the indexes of instantaneous PRV (iPRV) and instantaneous respiratory frequency (IF_resp) of arterial blood pressure signals using empirical mode decomposition and normalized direct-quadrature algorithms. iPRV consists of low-frequency (LF), high-frequency (HF), and very high-frequency (VHF) bands. Moreover, a novel method of extended classifier system with continuous real-coded variables (XCSR) was used to detect GD and extract GD-related iPRV features using iPRV and IF_resp as input data.

Results

A total of 32 college students without depressive and anxiety symptoms or cardiovascular diseases were recruited in this study. Participants were grouped into the high-risk GD and low-risk GD using both Chen Internet Addiction Scale and Internet Gaming Disorder Questionnaire. Their arterial blood pressures signals were measured while they watched gameplay videos with negative or positive emotional stimuli. Seven participants with high-risk GD exhibited significantly increased normalized VHF (nVHF) PRV and IF_resp readings and significantly decreased normalized LF (nLF) PRV readings and LF/HF PRV ratios (from baseline) during negative or positive gameplay videos stimuli. These participants also exhibited higher nVHF PRV and lower nLF PRV readings and LF/HF PRV ratios when they experienced negative gameplay video stimuli relative to 17 participants with low-risk GD. The classification accuracy of the XCSR reached 90% for both negative and positive video stimuli, and nVHF PRV was most frequently used to detect GD risk.

Conclusions

iPRV and IF_resp can be used to detect GD and analyze the autonomic mechanism of individuals with GD.

[Examining the effects of dissonance-based primary prevention of Internet and computer-game addiction on attitudes toward gaming among grade 5 pupils: A pilot study]

Examining the effects of dissonance-based primary prevention of Internet and computer-game addiction on attitudes toward gaming among grade 5 pupils: A pilot study Abstract. Objective: To date, childhood has hardly been considered in the development of effective prevention and intervention programs for gaming disorder and Internet addiction. PROTECTdissonance was therefore designed as a 1-hour dissonance-based, universal primary prevention program for grade 5 high-school students. This pilot study examines the immediate effects of dissonance induction on attitudes toward gaming. Method: A single-arm A+B design with three measurement points (T0, T1, T2) assessed attitudes toward gaming using the Gaming Attitude Test (GAT). The baseline sequence (sequence A, T0 to T1, subsample) included N = 83 high-school students (age: M = 10.27; SD = 0.48) and the intervention sequence (sequence B, T1 to T2, total sample) included N = 200 pupils (age: M = 10.24; SD = 0.47). Acceptance and satisfaction were recorded after the intervention. Results: Hierarchical linear growth models showed a significant reduction of GAT symptoms through the intervention, both in the total GAT score and on the subscale "Trivialization of Negative Consequences." There were no changes in the natural course (baseline sequence A). Pupils correspondingly reported a high rate of satisfaction with PROTECTdissonance. Conclusions: A brief, targeted dissonance-induction exercise shows immediate effects on an attitudinal measure of gaming. To follow up on this promising approach, future studies should investigate whether reduced trivialization of negative consequences of gaming is actually reflected in behavioral change.

Affective and cognitive processes involved in behavioral addictions

This special issue addresses the affective and cognitive processes and their interactions potentially reflecting mechanisms underlying the development, maintenance of, or recovery from behavioral addictions. Various specific types of behavioral addictions will be considered, including those already in ICD-11 (gambling disorder, gaming disorder), but also new phenomena that are not yet classified (e.g., buying-shopping disorder, social-network-disorder) and phenomena potentially belonging to behavioral addictions although they are currently classified elsewhere (e.g., compulsive sexual behavior disorder). The articles included in this special issue directly investigate affective processes (e.g., cue-reactivity, craving, mood, stress, social interactions) and/or cognitive processes (e.g., executive functions, attention, memory). The studies involve experimental paradigms, neuropsychological tasks, psychophysiological measures, and neuroimaging techniques. Specific articles also deal with the relationship between affective and cognitive processes. The special issue is complemented by articles covering current debates and reviewing current empirical findings in the field.

Gaming Disorder in Adults with Autism Spectrum Disorder

Gaming disorder (GD) is a clinical addiction to video or internet games. This study investigated whether GD symptoms are heightened in adults with autism spectrum disorder (ASD) in comparison to a control group, and explored predictors of GD in 230 adults with ASD and 272 controls. The relationship between GD and gelotophobia was examined. Measures included the Ten-Item Internet Gaming Disorder Test, GELOPH < 15 >, Autism Spectrum Quotient-10 items, Inventory of Parent and Peer attachment, Emotional Regulation Questionnaire, Social Functioning Questionnaire (SFQ) and the NEO-FFI-3. Individuals in the ASD group showed significantly higher symptoms of GD. Peer-attachment, emotional regulation and extraversion significantly predicted GD scores. Gelotophobia and GD were related to each other with a small effect size.

Problematic Gaming in Youth and Its Association with Different Dimensions of Quality of Life

Objective: The problematic use of computer games was included in the DSM-5 and in the ICD-11. Initial research revealed associations between problematic gaming (PG) and quality of life (QoL). However, clarification is needed concerning which dimensions of the multidimensional construct QoL are particularly relevant for PG. Method: To answer this question empirically, we asked 503 parents (mean age: 47.63 years) to rate their 503 children (average age: 14.60 years) regarding QoL and PG, using validated questionnaires on parental assessments of adolescent PG and health-related QoL to collect the data. Correlation analyses were calculated to determine bivariate relations, and a multiple linear regression was used to conduct a multivariable analysis. Results: In the bivariate analyses, a higher severity of PG was associated with a lower health-related QoL in all five surveyed dimensions. In the multivariable model (corrected R² = 0.35), we observed statistically significant associations between higher severity of PG and male sex and lower age of the adolescent as well as lower QoL in the dimensions of physical well-being and school environment. Conclusions: According to the findings of the present study, physical well-being and school environment should be especially focused on in preventive approaches against the development of PG in youth.

Global prevalence of gaming disorder: A systematic review and meta-analysis

BACKGROUND

Gaming disorder was included in the latest revision of the International Classification of Diseases (11th ed.). Worldwide, prevalence estimates of gaming disorder are considerably heterogeneous and often appear to be exceedingly high. However, few studies have examined the methodological, cultural and/or demographic factors that might explain this phenomenon. This review employed meta-analytic techniques to compute the worldwide-pooled prevalence of gaming disorder and evaluate the potential contributing factors for varied prevalence estimates.

METHOD

Prevalence estimates were extracted from 53 studies conducted between 2009 and 2019, which included 226,247 participants across 17 different countries. Study findings were meta-analyzed using a random-effects model. Subgroup and moderator analyses examined potential sources of heterogeneity, including assessment tool and cut-off, participant age and gender, sample size and type, study region, and year of data collection.

RESULTS

The worldwide prevalence of gaming disorder was 3.05% (confidence interval: [2.38, 3.91]); this figure was adjusted to 1.96% [0.19, 17.12] when considering only studies that met more stringent sampling criteria (e.g. stratified random sampling). However, these estimates were associated with significant variability. The choice of screening tool accounted for 77% of the variance, with the Lemmens Internet gaming disorder-9, Gaming Addiction Identification Test and Problematic Videogame Playing scales associated with the highest estimates. Adolescent samples, lower cut-off scores and smaller sample size were significant predictors of higher prevalence. Gaming disorder rates were approximately 2.5:1 in favor of males compared to females.

CONCLUSION

The worldwide prevalence of gaming disorder appears to be comparable to obsessive-compulsive disorder and some substance-related addictions, but lower than compulsive buying and higher than problem gambling. Gaming disorder prevalence rates appear to be inflated by methodological characteristics, particularly measurement and sampling issues.

Person-centred interventions for problem gaming: a stepped care approach

BACKGROUND

Problem gaming is reported by approximately 1-3% of the population and is associated with decreased health and wellbeing. Research on optimal health responses to problem gaming remains limited. This study aimed to identify and describe the key components of a person-centred approach to interventions for problem gaming for individuals who voluntary seek assistance.

METHODS

Online interviews were conducted with 20 adults (90% male; M_age = 23y) currently seeking help for problem gaming. The interview protocol was guided by a health care access framework which investigated participants' experiences and needs related to accessing professional support. Transcripts were analysed in NVivo using qualitative content analysis to systematically classify participant data into the themes informed by this framework.

RESULTS

Participants had mixed views on how the negative consequences of problem gaming could be best addressed. Some indicated problems could be addressed through self-help resources whereas others suggested in-person treatment with a health professional who had expertise in gaming. Participants described the essential components of an effective health service for problem gaming as including: valid and reliable screening tools; practitioners with specialist knowledge of gaming; and access to a multimodal system of intervention, including self-help, internet and in-person options that allow gamers to easily transition between types and intensity of support.

CONCLUSION

A comprehensive health care approach for interventions for problem gaming is in its infancy, with numerous service access and delivery issues still to be resolved. This study highlights the importance of involving individuals with gaming-related problems in developing solutions that are fit for purpose and address the spectrum of individual preferences and needs. These findings recommend a stepped healthcare system that adheres to evidence-based practice tailored to each individual and the implementation of standard assessment and routine outcome monitoring.

Prevention Strategies to Address Problematic Gaming: An Evaluation of Strategy Support Among Habitual and Problem Gamers

Psychosocial problems arising from excessive gaming are a public health issue across the developed world. In its most serious form, problematic gaming is recognized as gaming disorder (GD) in the ICD-11. Research has tended to focus on the value of outpatient treatment for GD, but less attention has been paid to broader prevention strategies to address less serious but nevertheless harmful gaming behaviors. Another gap in this literature has been the lack of involvement of the gaming community as stakeholders to identify feasible prevention approaches. This study investigated: (1) regular and problematic gamers' level of support for different prevention strategies within primary, secondary, and tertiary approaches; and, (2) whether self-efficacy is associated with greater support for prevention strategies, as predicted by the Health Belief Model. A total of 992 participants completed an online survey that evaluated support for problem gaming prevention strategies and included measures of self-efficacy, gaming involvement, and GD symptoms, psychological distress, and mental health help-seeking behaviors. Participants reported stronger support for primary prevention strategies, including education, screening, and warning labels, than for other prevention approaches. Overall, 61% of participants expressed support for primary prevention as compared to secondary (39%) and tertiary (36%) approaches. There was stronger support for outpatient care (48%) than inpatient services (25%). In-game shutdown features received the lowest support (65% disapproval). Contrary to the Health Belief Model, self-efficacy was not associated with prevention support. Younger, female, and less frequent gamers were more likely to support primary and secondary prevention strategies. These findings suggest that gamers may be more favorable toward prevention measures aligned with informed decision-making, autonomy, and self-directed actions. Gamers may be strongly opposed to modifications to the structure of gaming activities (e.g., shutdown features). Future research should evaluate the efficacy and cost-effectiveness of problem gaming prevention measures in different populations and regions.

Symptoms of Internet Gaming Disorder, Inattention, and Impulsivity: a Cross-Sectional Study Conducted in the United Arab Emirates

The addictive use of internet video games is now recognized as a valid diagnostic construct by both the World Health Organization and the American Psychiatric Association. A burgeoning body of preliminary evidence points to a relationship between attention deficit and hyperactivity disorder (ADHD) symptoms as being a risk factor for behaviors indicative of internet gaming disorder (IGD), however, studies have rarely examined ADHD's two diagnostic constructs, inattention and impulsivity, separately. Moreover, IGD research is non-existent in Middle Eastern contexts. Therefore, this study examined, separately, the association of IGD with inattention and impulsivity in a sample of gamers from the United Arab Emirates. A cross-sectional survey was completed by 214 participants aged 18-33 years (m_age = 20.64, SD = 4.34) who completed measures of IGD and ADHD, and self-reported daily duration of gameplay as well as a number of demographic characteristics. The pair of hierarchical linear regressions indicated that both the examined constructs, increased symptoms of inattention and impulsivity, were separately associated with elevated risk for engagement in IGD behaviors. However, these associations were not moderated by gender. These results confirm that symptoms of ADHD are indeed associated with IGD and is the first to confirm the presence of this relationship in a Middle Eastern sample.

The recognition of gaming disorder in China: a case series of 223 patients

Background

Internet gaming disorder (IGD) was listed in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a condition requiring further study in 2013, and gaming disorder (GD) was considered a mental disorder and listed in the 11th International Classification of Diseases Manual (ICD-11) in 2018. The study aims to obtain preliminary knowledge of the recognition of GD in China.

Methods

A total of 223 Chinese patients who met both the ICD-11 and DSM-5 criteria for GD participated in the study, and a self-administered questionnaire was used to collect demographic information, gaming use characteristics, and previous diagnoses.

Results

The average age of patients with GD was 20.5 years, and 71.3% were male. Most patients were diagnosed with emotion-related disorders at their first psychiatric visit: mood disorders (59.2%), bipolar affective disorder (18.4%), depressive episode (12.6%), and anxiety disorder (4.9%). Among the adolescent patients with a first diagnosis of mood disorders, 71.2% and 33.3% were diagnosed with bipolar affective disorder and personality disorders, respectively, at subsequent visits. Overall, after the first visit, the most common diagnosis was bipolar affective disorder (61.0%), followed by personality disorders (34.1%), mood disorders (17.0%), depressive episode (17.0%), and other disorders. Only three patients had Internet overuse.

Conclusion

The identification rate of GD is extremely low in routine psychiatric clinical practice in China. Most patients with GD were previously misdiagnosed with emotion-related disorders. Psychiatrists should be trained to improve their ability to recognize and manage GD.