Depression, Internet Gaming Disorder, and the Moderating Effect of the Gamer-Avatar Relationship: an Exploratory Longitudinal Study

Proteus Effect Profiles: how Do they Relate with Disordered Gaming Behaviours?

Gamers represent themselves in online gaming worlds through their avatars. The term "Proteus Effect" (PE) defines the potential influences of the gamers' avatars on their demeanour, perception and conduct and has been linked with excessive gaming. There is a significant lack of knowledge regarding likely distinct PE profiles and whether these could be differentially implicated with disordered gaming. A normative group of 1022 World of Warcraft (WoW) gamers were assessed in the present study (Mean _age = 28.60 years). The Proteus Effect Scale (PES) was used to evaluate the possible avatar effect on gamers' conduct, and the Internet Gaming Disorder Scale-Short-Form was used to examine gaming disorder behaviors. Latent class profiling resulted in three distinct PE classes, 'non-influenced-gamers' (NIGs), 'perception-cognition-influenced-gamers' (PCIGs), and 'emotion-behaviour-influenced-gamers' (EBIGs). The NIGs reported low rates across all PES items. The PCIGs indicated higher avatar influence in their perception-experience but did not report being affected emotionally. The EBIGs indicated significantly higher avatar influence in their emotion and behaviour than the other two classes but reported stability in their perception of aspects independent of their avatar. Gaming disorder behaviours were reduced for the NIGs and progressively increased for the PCIGs and the EBIGs.

Avatar- and self-related processes and problematic gaming: A systematic review

The concept of self has become increasingly relevant to understanding the psychological mechanisms of problematic online gaming. Many gaming activities feature in-game avatars that enable the adoption of, and experimentation with, different roles and identities. Avatars enable players to compensate for perceived deficiencies in their real-world self (e.g., lack of physical strength, beauty, or social status). Currently, how avatar- and self-related processes may develop and maintain problematic gaming, including gaming disorder (GD), is unclear. This systematic review examined 18 quantitative studies of avatar- and self-related concepts and problematic gaming, including 13 survey-based and 5 neuroimaging studies. Despite variability in the conceptualization and measurement of avatar/self-related concepts, survey-based studies have consistently reported that negative self-concept, avatar identification, and large self-avatar discrepancies are significantly associated with problematic gaming. Poor self-concept appears to be a risk factor for GD, particularly for games that facilitate role-playing and identity formation. Further research and clinical evidence are needed to explain how avatar- and self-related processes may relate to the addictive mechanisms of GD (e.g., cognitive distortions, reward-seeking, inhibitory control, self-regulation systems), amid calls for problem gaming-related assessment and interventions to incorporate a focus on avatar identification.

Gaming disorder and internet addiction: A systematic review of resting-state EEG studies

Neurophysiological studies of Gaming Disorder (GD) and internet addiction (IA) are providing important insight into neurocognitive mechanisms underpinning these disorders, which will enable more accurate diagnostic classification. Electroencephalography (EEG) has been widely used to investigate addictive behaviours, and offers advantages of accessibility, low cost, and excellent temporal resolution. The present systematic review evaluates resting-state EEG studies in GD and IA. Papers (n = 7293) were identified in the PsychARTICLES, PsychINFO, Scopus, and Pubmed databases. Following inclusion/exclusion criteria, ten studies remained for evaluation. Results suggest individuals with GD have raised delta and theta activity and reduced beta activity, with coherence analysis suggesting altered brain activity in the mid-to-high frequency range. IA individuals demonstrate raised gamma activity and reduced beta and delta activity. Results suggest that the altered brain activity found in GD/IA may represent distinct underlying neurophysiological markers or traits, lending further support to their unique constructs. Results are also discussed in relation to relevant psychometric measurements and similar (higher frequency) activity found in substance addiction. Future research should focus on replicating the findings in a wider variety of cultural contexts to support the neurophysiological basis of classifying GD and IA.

Inattention and Disordered Gaming: Does Culture Matter?

Problematic gaming has emerged as a contemporary concern, leading to the introduction of the diagnostic term 'Internet Gaming Disorder' (IGD; American Psychiatric Association). The present study aims to empirically assess the association between inattention and IGD, in the light of variable levels of vertical-individualism that reflects cultural inclinations towards independence, competitiveness, and hierarchy. The participants (N = 1032) comprised a normative cohort of Massively Multiplayer Online (MMO) gamers (Mage = 24 years; 48.7% male). IGD was measured with the nine-item short-form IGD Scale (IGD9-SF), inattention with the Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale, and vertical individualism with the Individualism-Collectivism Questionnaire. Complex hierarchical and moderated regressions were employed. Findings demonstrated an association between IGD and inattention, and additionally showed that this association was exacerbated by a more vertically-individualistic cultural orientation without significant gender differences. The need of differentially addressing IGD risk among inattentive gamers of diverse cultural orientation is highlighted.

“Who Am I” and “How Should I Be”: a Systematic Review on Self-Concept and Avatar Identification in Gaming Disorder

Purpose of Review

Gaming disorder (GD) appears to be associated with self-concept deficits and increased identification with one’s avatar. The goal of this literature review is to highlight study findings assessing psychological and neurobiological correlates of self-concept-related characteristics and avatar identification in GD.

Recent Findings

The review was based on three literature researches on GD: (1) self-esteem, (2) emotional, social, and academic self-concept domains and avatar identification, and (3) neurobiological correlates of self-concept and avatar identification. The results indicate that GD is associated with decreased self-esteem as well as deficits in physical, social, and emotional self-concept domains. A relatively stable relationship between higher avatar identification and GD was reported in addicted gamers. Furthermore, addicted gamers showed increased activation of brain regions associated with Theory-of-Mind processing while contemplating their own avatar.

Summary

The results point towards impairments in self-concept and increased identification with the virtual gaming character in addicted gamers. This virtual compensation fosters the formation of an idealized self-concept, which grows increasingly distant from their own self-image. Thus, additional empirically based psychological interventions should focus on the development of a realistic self-image by reducing the dysfunctional discrepancy between the ideal self and the real self.

User-avatar bond profiles: How do they associate with disordered gaming?

AIMS

The avatar constitutes the in-game representation of the gamer. Although aspects of the user-avatar bond (UAB) have been associated with disordered gaming, there is a need for clearer understanding concerning the impact of potential UAB profiles.

METHODS

To address this need, the present study recruited a normative sample of 1022 World of Warcraft (WoW) players (M_age = 28.55 years, SD = 9.90). Participants completed the User-Avatar Questionnaire (to assess UAB aspects such as identification, immersion, and compensation), the Proteus-Effect Scale (to assess transference of the avatar's behaviour in real life), and the Internet Gaming Disorder Scale-Short-Form (to assess disordered gaming).

RESULTS

Latent class analysis indicated the existence of three UAB profiles, 'differentiated gamers' (DGs), 'identified gamers' (IGs) and 'fused gamers' (FGs). The DGs were characterized by low scores across all UAB aspects. The IGs did not report significant Proteus Effect (PE) or immersion behaviours, and despite being more identified with their avatar, did not significantly compensate through it. The FGs presented with higher PE, immersion, and compensation, although they did not significantly identify with their avatars, possibly due to having idealized them. Disordered gaming behaviours were significantly lower for the DGs and sequentially higher for the IGs and the FGs. Preoccupation and mood modification behaviours related to gaming disorder were distinctively associated with FGs.

CONCLUSION

Disordered gaming assessment and treatment implications of the UAB profiles are discussed.

Measurement, Profiles, Prevalence, and Psychological Risk Factors of Problematic Gaming Among the Turkish Community: A Large-scale National Study

The present study investigated the prevalence, the potential different profiles, and the associated psychological factors of disordered gaming using data from a large-scale epidemiological study (TURBAHAR [Turkey’s Addiction and Mental Health Risk Profile Map Project]) carried out in Turkey in 2018 with 24,494 participants aged 18–81 years. Participants completed a comprehensive survey comprising a demographic questionnaire, Gaming Addiction Risk Questionnaire, Brief Symptom Inventory, Personal Well-Being Index Adult Form, Positive and Negative Affect Schedule, Toronto Alexithymia Scale, and Experiences in Close Relationships-Revised Scale. Latent class analysis showed the existence of eight different game profiles, which differed in relation to the intensity and specific features of the behavior. Results showed that 1.6% of the participants were problematic gamers. Being male, being younger, lower education level, being single, using alcohol and cigarettes, psychiatric distress, positive and negative affect, and anxious adult attachment were positively associated with problematic gaming.

Depression and Disordered Gaming: Does Culture Matter?

The dearth of evidence related to cultural and gender variations of established associations between Internet Gaming Disorder (IGD) and other psychopathologies has been highlighted. Accordingly, the present study examined the association between depression and disordered gaming behaviors, while considering cultural perspectives of vertical individualism (independence and hierarchy) and gender as potentially variating factors. To achieve this, an ethnically diverse online sample of internet gamers from multicultural societies (N = 1032; Australia = 738; 71.5%; USA = 222; 21.5%; other multicultural countries = 72; 13.3%; Mage = 24 years; males = 503 [48.7%], females = 529 [51.3%]) completed the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF); the Depression, Anxiety and Stress Scale (DASS-21) and the Individualism and Collectivism Scale (ICS). Regression, moderation and moderated moderation analyses were conducted. Results demonstrated that gamers presenting concurrently with symptoms of depression and vertically individualistic inclinations reported higher levels of disordered gaming behaviors, with no significant gender differences. The findings obtained imply that practitioners globally, and especially in multicultural societies (e.g., Australia, USA), should consider cultural differences when developing prevention and intervention strategies for disordered gaming.

Psychometric Evaluation and Comparison of Two Gaming Disorder Measures Derived From the DSM-5 and ICD-11 Frameworks

Gaming disorder was listed as a condition for further study in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, and measures of the disorder have mushroomed in the years since. The Gaming Disorder Test (GDT) was developed after gaming disorder was officially included in the 11th Revision of the International Classification of Diseases (ICD-11) in 2018. However, it remains unknown whether the GDT, which is based on the ICD-11 framework, is psychometrically similar to or different from the popular nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF) based on the DSM-5 framework. To address this important but unexplored issue, the present study evaluated and compared the psychometric properties of the GDT and IGDS9-SF in a sample of 544 adult gamers (56.2% men; mean age = 28.8, SD = 8.55). The results revealed both measures to have good reliability, structural validity, and criterion validity, with the exception of one IGDS9-SF item with a low factor loading. Moreover, the IGDS9-SF exhibited scalar measurement invariance for gender and age but only partial metric invariance for employment status, whereas the GDT exhibited scalar measurement invariance for all three demographic characteristics. Finally, the GDT displayed incremental validity over the IGDS9-SF in explaining gaming time, but not social anxiety and depressive symptoms. This study thus contributes to the literature by comparing measures derived from distinct gaming disorder diagnostic frameworks empirically. Recommendations for the selection of gaming disorder measures by researchers and practitioners are discussed.

Purpose in life, social support, and internet gaming disorder among Chinese university students: A 1-year follow-up study

AIMS

Given the high prevalence of Internet gaming disorder (IGD) among university students and the beneficial effects of positive psychological factors on mental illness, the present longitudinal research aimed to investigate whether purpose in life and social support yields long-term results in protecting university students from IGD.

METHODS

We recruited 469 Chinese university students to voluntarily fill out an anonymous questionnaire at baseline, and 283 of them were followed up and given similar measures after one year.

RESULTS

The prevalence of probable IGD at the baseline and follow-up surveys was 14.8% and 9.9% respectively. Purpose in life and social support were negatively correlated with IGD symptoms in both surveys (p < .05). The results of a cross-lagged analysis showed that purpose in life, but not social support, assessed at baseline predicted fewer IGD symptoms at follow-up (p < .001). In addition, social support and purpose in life predicted one another across time.

CONCLUSIONS

The prevalence of probable IGD was high among Chinese university students. Purpose in life was shown to be an effective significant protective factor against IGD, while the effect of social support might be indirect. Positive psychology interventions, which promote the search for and attainment life purpose, may be incorporated in school-based program for IGD prevention.

The Physical, Emotional, and Identity User-Avatar Association with Disordered Gaming: A Pilot Study

Internet gaming disorder (IGD) is a rapidly expanding psychopathological manifestation necessitating further research and clinical attention. Although recent research has investigated relationships between user-avatar and excessive gaming, little is known about the interplay between IGD and avatar self-presence and its dimensions (i.e., the physical, emotional, and identity bond developed between the user and the in-game character). The aim of the present pilot study was twofold: (i) to investigate the associations between physical, emotional, and identity aspects of self-presence associate and IGD severity, and (ii) to assess IGD variations longitudinally in relation to the three dimensions of self-presence (i.e., proto-self-presence, core-self-presence, and extended-self-presence). The sample comprised 125 young adults aged between 18 and 29 years who underwent either (i) three offline measurements (1 month apart, over 3 months) or (ii) a cross-sectional online measurement. Regression and latent growth analysis indicated that the initial intensity of the physical, emotional, and identity self-presence aspects associated with IGD severity, but not to its longitudinal change. Overall, young adult gamers may exhibit higher IGD risk and severity when the experience of physical, emotional, and identity bonding with their in-game character is pronounced. The implications surrounding treatment and preventative policy recommendations are further discussed.

Measurement and Conceptualization of Gaming Disorder According to the World Health Organization Framework: the Development of the Gaming Disorder Test

Previous research on gaming disorder (GD) has highlighted key methodological and conceptual hindrances stemming from the heterogeneity of nomenclature and the use of non-standardized psychometric tools to assess this phenomenon. The recent recognition of GD as an official mental health disorder and behavioral addiction by the World Health Organization (WHO) in the 11th Revision of the International Classification of Diseases (ICD-11) opens up new possibilities to investigate further the psychosocial and mental health implications due to excessive and disordered gaming. However, before further research on GD can be conducted in a reliable way and within a robust cross-cultural context, a valid and reliable standardized psychometric tool to assess the construct as defined by the WHO should be developed. The aim of this study was to develop The Gaming Disorder Test (GDT), a brief four-item measure to assess GD and to further explore its psychometric properties. A sample of 236 Chinese (47% male, mean age 19.22 years, SD = 1.57) and 324 British (49.4% male, mean age 26.74 years, SD = 7.88) gamers was recruited online. Construct validity of the GDT was examined via factorial validity, nomological validity, alongside convergent and discriminant validity. Concurrent validity was also examined using the Internet Gaming Disorder Scale—Short-Form (IGDS9-SF). Finally, reliability indicators involving the Cronbach’s alpha and composite reliability coefficients were estimated. Overall, the results indicated that GDT is best conceptualized within a single-factor structure. Additionally, the four items of the GDT are valid, reliable, and proved to be highly suitable for measuring GD within a cross-cultural context.

Need fulfilment and internet gaming disorder: A preliminary integrative model

BACKGROUND

The need for a better understanding of the risk factors underpinning disordered gaming has been consistently emphasized. Although, gaming may offer a simple and straightforward means of alleviating distress, relying on gaming to address one's unmet psychological needs could invite problematic usage. Self-determination theory highlights the significance of three universally inherent psychological needs for relatedness, competency, and autonomy. A motivation to engage in gaming may be to address unmet needs and may become problematic.

OBJECTIVE

This study aimed to assess whether experienced levels of loneliness, depression and self-esteem mediate the association between Internet Gaming Disorder (IGD) behaviours and Need-Fulfilment deficits.

METHOD

The participants comprised of 149 adults (83 males, 66 females), aged between 18 and 62 years. A series of self-reported questionaries assessing their levels of IGD behaviours, depression, loneliness, self-esteem and need-fulfilment were completed.

RESULTS

Need-fulfilment deficits were linked to higher IGD behaviours. Interestingly, this association was mediated by the reported levels of self-esteem and depression and not loneliness.

CONCLUSIONS

The findings lend further empirical support for the mediating role of psychological distress between need fulfilment deficits and IGD behaviours.

Associations between attention deficit hyperactivity and internet gaming disorder symptoms: Is there consistency across types of symptoms, gender and countries?

BACKGROUND

Videogame addiction has been suggested as a tentative disorder in 2013 by the American Psychiatric Association (APA) and was recently officially recognized as a mental health disorder by the World Health Organization (WHO). Although a few studies have identified attention deficit and hyperactivity disorder (ADHD) as a key risk factor for Internet Gaming Disorder (IGD), the interplay between ADHD and IGD symptoms with gender differences across cultures remains to be further examined.

OBJECTIVE

This study examined the moderating effects of gender in the association between ADHD and IGD across two nations.

METHOD

A cross-sectional online survey was developed to recruit 164 Australian (Mage = 23.01, SD = 3.35, Minage = 18, Maxage = 31, Males n = 121, 73.80%) and 457 U.S.-North American (Mage = 25.25 years, SD = 2.76, Minage = 18 years, Maxage = 29 years, Males = 265, 57.98%) Massively Multiplayer Online (MMO) players aged between 18 and 29 years.

RESULTS

The hierarchical linear regression, moderation and moderated moderation analyses revealed that participants presenting greater inattention and hyperactivity symptoms exhibited higher levels of IGD-related behaviors in the two samples. Moreover, these associations differed across genders between the two countries. Specifically, more hyperactive-impulsive, as well as inattentive males in the USA presented higher levels of disordered gaming.

CONCLUSION

The results highlight the need for more cross-cultural and symptom-focused research in the broader IGD field.

Test-Retest Measurement Invariance of the Nine-Item Internet Gaming Disorder Scale in Two Countries: A Preliminary Longitudinal Study

The reliable longitudinal assessment of Internet Gaming Disorder (IGD) behaviors is viewed by many as a pivotal clinical and research priority. The present study is the first to examine the test-retest measurement invariance of IGD ratings, as assessed using the short-form nine-item Internet Gaming Disorder Scale (IGDS9-SF) over an approximate period of 3 months, across two normative national samples. Differences referring to the mode of the data collection (face-to-face [FtF] vs. online) were also considered. Two sequences of successive multiple group confirmatory factor analyses (CFAs) were calculated to longitudinally assess the psychometric properties of the IGDS9-SF using emergent adults, gamers from (i) the United States of America (USA; N = 120, 18–29 years, Meanage = 22.35, 51.6% male) assessed online and; and (ii) Australia (N = 61, 18–31 years, Meanage = 23.02, 75.4% male) assessed FtF. Configural invariance was established across both samples, and metric and scalar invariances were supported for the USA sample. Interestingly, only partial metric (factor loadings for Items 2 and 3 non-invariant) and partial scalar invariance (i.e., all thresholds of Items 1 and 2, and thresholds 1, 3, for Items 4, 6, 8, and 9 non-invariant) were established for the Australian sample. Findings are discussed in the light of using IGDS9-SF to assess and monitor IGD behaviors over time in both in clinical and non-clinical settings.

Assessing Online Flow Across Cultures: A Two-Fold Measurement Invariance Study

The association between online Flow and Internet Gaming Disorder (IGD) has attracted significant attention. Despite the consensus that online Flow plays a pivotal role in the development of IGD and other Internet addictive behaviors, there has been a lack of consistency in measurement scales used to assess online Flow. Even widely used measures of online Flow have not been psychometrically assessed across culturally diverse populations of gamers. Such an assessment would enhance the accuracy of cross-cultural comparisons. Attending to this need, the present study assessed the psychometric properties of the binary coded (i.e., Yes, No) Online Flow Questionnaire (OFQ), while concurrently taking into consideration country, age, language, and mode of data collection (online or face-to-face) differences. Two sequences of successive multiple group confirmatory factor analyses were used to assess the psychometric properties of the OFQ, between: (a) emergent adults from the United States of America (N = 482, Mage = 25.23, SD = 2.746) and Australia (N = 168, Mage = 23.55, SD = 3.37) and (b) adolescents from Greece (N = 1579, Mage = 16.12, SD = 0.849) and Cyprus (N = 1372, Mage = 15.54, SD = 0.656). Configural and partial metric invariance were confirmed between the United States and Australian samples. For the Greek and Cypriot samples, results indicated full configural and metric invariance. These results provide initial information to researchers and clinicians of the extent to which the OFQ maintains its consistency when used across cultures and invite for further cross-cultural studies in the field. Implications, as well as limitations, are discussed.

Internet gaming disorder: Feeling the flow of social games

Introduction

Gaming Disorder (GD) was added to the recent publication of the International Classification of Diseases (ICD-11) by the World Health Organization. This aligns with recommendations of the fifth edition of the Diagnostic Statistical Manual for Mental Disorders (DSM-5), issued by the American Psychiatric Association. Accordingly, further relevant research has been invited. The interplay between preference for online social game genres, the degree of online Flow (or immersive pleasure) experienced, and the gamer's biological gender were examined here as contributing factors of IGD.

Method

A normative sample of adult internet gamers was collected online (N = 237, Age = 18-59, Males = 157; 66%; Females = 80; 34%). Participants completed the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), the Online Flow Questionnaire (OFQ), and also self-reported demographics and internet/gaming behaviours.

Results

Mediation and moderated mediation analyses indicated that the level of online Flow experienced considerably mediated the association between the preference for social games genres and the intensity of IGD behaviours across both biological genders.

Conclusions

Results suggest that the level of online Flow experienced constitutes a risk factor in relation to the development of IGD. Furthermore, games which mandate social interaction with others present to be conducive to online Flow, and thus enhancing IGD risk irrespective of the biological gender of the gamer. Implications and limitations of the study are discussed.