Internet gaming disorder in early adolescence: Associations with parental and adolescent mental health

Prevalence and associated factors of internet gaming disorder among secondary school students in rural community, Thailand: a cross-sectional study

Objective

Internet gaming disorder (IGD) is an emerging mental problem for adolescent that has been increasingly piqued interest over the last decade. Although many studies have been conducted, very few studies have studied populations with low technological access. Therefore, this study aimed to estimate the prevalence and associated factors of internet gaming disorder among secondary school students in an area with a comparatively lower technological access in a large community sample. We used Chachoengsao province, Thailand as our sample area with a comparatively lower access to technology. This cross-sectional study was conducted during December 2017–January 2018 among 12 secondary schools in Chachoengsao province, Thailand.

Results

5.4% of the 5497 subjects were positive for IGD. The associated factors found were male gender (odds ratio (OR) = 1.4), not living with both parents (OR = 1.75), use of online dating (OR = 1.53), being bullied at school (OR = 1.51), depression (OR = 1.92), anxiety (OR = 1.62) and stress (OR = 3.57) after being adjusted for age, family composition, failure of an exam, limit of internet use, use of online dating, bully perpetration, bully victimization, cyber bully perpetration, cyber bully victimization, suicidal ideation, use of alcohol, depression, anxiety, and stress.

The role of family and personality traits in Internet gaming disorder: A mediation model combining cognitive and attachment perspectives

BACKGROUND AND AIMS

Gaming disorder was recently recognized as a mental health disorder by the World Health Organization and included in the International Classification of Diseases. Extensive research has been conducted with regard to psychosocial correlates and comorbidity, less so for the developmental mechanisms and the processes leading to the disorder. The association between family factors, personality traits, and gaming has been studied independently but not in combination. To fill this gap in knowledge, this study examined (a) the association between parental acceptance-rejection theory and Internet gaming disorder (IGD) and (b) the mediating and moderating effect of core self-evaluations (CSE), a personality construct, on the aforementioned variables.

METHODS

The study was quantitative and involved young adults members of online gaming communities (N = 225).

RESULTS

The results showed that parental rejection is associated with the occurrence of IGD, only through the mediating effect of CSE. The moderation model was not confirmed.

DISCUSSION

Findings bridge early emotional deficits with CSE personality traits and IGD, based on two widely acknowledged theoretical frameworks. In addition, they highlight the importance of the father's role in upbringing.

CONCLUSIONS

These frameworks combine cognitive and attachment perspectives and a process-oriented approach to the development and maintenance of IGD. The implications of these findings are discussed in relation to (a) the mechanisms leading to the disorder and (b) providing an evidence base for therapeutic interventions for IGD to go beyond abstinence and include self-esteem enhancement and efficacy contingencies. Directions for future research are also provided in this study.

Adverse Childhood Experiences and Avatar Preferences in Online Games

This study investigates the relationship between adverse childhood experiences (ACEs), age, and sex with respect to their avatar preference in online games. The analyses comprise a subsample of n = 1817 adolescents and adults from 14 to 60 years within a representative German population-based study. Results indicate that 14 % of this sample uses avatars in online games, with significantly more males (22.6 %) than females (7.7 %) doing so. Persons with multiple ACEs (≥ 4) have a higher OR of 2.05 (95 % CI: 1.418-2.956) to use avatars in online games. Regarding avatar preference, females are more likely to play supporters than males, and males are more likely to choose damagers and mixed-type avatars than females. Participants with an experience of parental divorce during their childhood reported higher preference of playing supporter or mixed-type avatars in comparison with damager avatars. Moreover, participants with mental illness or suicide in the family show a higher preference of mixed-type avatars compared to damager, but not to supporter avatars. Knowledge about the use of avatars can be an interesting source of information for supporting psychotherapeutic treatment in a young age group.

Bio-psychosocial factors of children and adolescents with internet gaming disorder: a systematic review

Previous large-scale studies suggest that internet gaming disorder (IGD) among children and adolescents has become an important public concern. Minors are known to be particularly susceptible to problematic internet gaming use owing to age-related underdevelopment of cognitive control. It has been shown that precursors of addictions appear during adolescence; therefore, prevention efforts must be established targeting minors who have their first experience with addictive substances and behaviors during pubescence. Since the DSM-5 classification of IGD in 2013, studies on IGD have drastically increased in number. Thus, we performed an updated review of studies of IGD in children and adolescents to assess the clinical implications of IGD. The search included all publication years, using PubMed, MEDLINE, and PsycINFO. Across studies, the presence of IGD had a negative effect on sleep and schoolwork in minors. Additionally, family factors, including the quality of parent-child relationships, were important social factors in minors with IGD. Brain imaging studies indicate that impaired cognitive control in minors with IGD is associated with abnormal function in the prefrontal cortex and striatum. Persistent pathological online game use from childhood may aggravate abnormal brain function; therefore, preventive care and early intervention are increasingly important. Although extant research supports the effectiveness of cognitive behavioral therapy for minors with IGD, effective psychological intervention for minors with IGD is an urgent issue that requires further research. This review, which presents updated findings of IGD in minors, is expected to contribute to the development of future research and be useful in clinical practice in the field of child and adolescent psychiatry.

Application of Diagnostic Interview for Internet Addiction (DIA) in Clinical Practice for Korean Adolescents

The increased prevalence of Internet Gaming Disorder (IGD) and the inclusion of IGD in DSM-5 and ICD-11 emphasizes the importance of measuring and describing the IGD symptoms. We examined the psychometric properties of the Diagnostic Interview for Internet Addiction (DIA), a semi-structured diagnostic interview tool for IGD, and verified the application of DIA in clinical practice for Korean adolescents. The DIA is conducted in a manner that interviews both adolescents and their caregivers, and each item has a standardized representative question and various examples. It consists of 10 items based on the DSM-5 IGD diagnostic criteria, which is cognitive salience, withdrawal, tolerance, difficulty in regulating use, loss of interest in other activities, persistent use despite negative results, deception regarding Internet/games/SNS use, use of Internet/games/SNS to avoid negative feelings, interference with role performance, and craving. The study included 103 adolescents divided into three subgroups (mild risk, moderate risk, and addicted group) based on the total score of DIA. Demographic and clinical characteristics were compared among the DIA subgroups using the chi-square test and analysis of variance (ANOVA), and correlation analysis was used to examine the associations of IGD symptoms with clinical variables (e.g., impulsivity, aggression, depression, anxiety, self-esteem). The DIA total score was significantly correlated with Internet and smartphone addiction, depression, state anxiety, self-esteem, impulsivity, aggression, and stress. Furthermore, the moderate risk and addicted group showed significantly higher levels of Internet and smartphone addiction, anxiety, depression, impulsivity, aggression, stress, and lower self-esteem compared with the mild risk group. The Junior Temperament and Character Inventory (JTCI), which measures temperament and character traits, revealed that the mild risk group had higher levels of persistence and self-directedness than did the addicted group. Our findings confirmed the psychometric properties of DIA and the application of the DIA classifications in Korean adolescents.

A longitudinal study on psychosocial causes and consequences of Internet gaming disorder in adolescence

BACKGROUND

In 2013, Internet gaming disorder (IGD) was incorporated in the current version of the DSM-5. IGD refers to a problematic use of video games. Longitudinal studies on the etiology of IGD are lacking. Furthermore, it is currently unclear to which extent associated psychopathological problems are causes or consequences of IGD. In the present survey, longitudinal associations between IGD and adolescent and parental mental health were investigated for the first time, as well as the temporal stability of IGD.

METHODS

In a cross-lagged panel design study, family dyads (adolescent with a parent each) were examined in 2016 (t1) and again 1 year later (2017, t2). Overall, 1095 family dyads were assessed at t1 and 985 dyads were re-assessed at t2 with standardized measures of IGD and several aspects of adolescent and parental mental health. Data were analyzed with structural equation modeling (SEM).

RESULTS

Male gender, a higher level of hyperactivity/inattention, self-esteem problems and IGD at t1 were predictors of IGD at t2. IGD at t1 was a predictor for adolescent emotional distress at t2. Overall, 357 out of the 985 adolescents received a diagnosis of IGD at t1 or t2: 142 (14.4%) at t1 and t2, 100 (10.2%) only at t1, and 115 (11.7%) only at t2.

CONCLUSIONS

Hyperactivity/inattention and self-esteem problems seem to be important for the development of IGD. We found first empirical evidence that IGD could prospectively contribute to a deterioration of adolescent mental health. Only a subgroup of affected adolescents showed IGD consistently over 1 year.

School-based Prevention for Adolescent Internet Addiction: Prevention is the Key. A Systematic Literature Review

Adolescents' media use represents a normative need for information, communication, recreation and functionality, yet problematic Internet use has increased. Given the arguably alarming prevalence rates worldwide and the increasingly problematic use of gaming and social media, the need for an integration of prevention efforts appears to be timely. The aim of this systematic literature review is (i) to identify school-based prevention programmes or protocols for Internet Addiction targeting adolescents within the school context and to examine the programmes' effectiveness, and (ii) to highlight strengths, limitations, and best practices to inform the design of new initiatives, by capitalizing on these studies' recommendations. The findings of the reviewed studies to date presented mixed outcomes and are in need of further empirical evidence. The current review identified the following needs to be addressed in future designs to: (i) define the clinical status of Internet Addiction (IA) more precisely, (ii) use more current psychometrically robust assessment tools for the measurement of effectiveness (based on the most recent empirical developments), (iii) reconsider the main outcome of Internet time reduction as it appears to be problematic, (iv) build methodologically sound evidence-based prevention programmes, (v) focus on skill enhancement and the use of protective and harm-reducing factors, and (vi) include IA as one of the risk behaviours in multi-risk behaviour interventions. These appear to be crucial factors in addressing future research designs and the formulation of new prevention initiatives. Validated findings could then inform promising strategies for IA and gaming prevention in public policy and education.

The Prevalence and Psychosocial Correlates of Internet Gaming Disorder

BACKGROUND

Internet gaming disorder (IGD) is the problematic use of computer games (whether online or offline) Its prevalence throughout Germany among children, adolescents, and young adults has not yet been estimated.

METHODS

A representative sample of 1531 12- to 25-yearolds in Germany was studied in September 2016 with a standardized instrument (Internet Gaming Disorder Scale, IGDS). Sociodemographic and psychosocial data about the participants were also obtained. Prevalence estimates and binary logistic regressions were calculated (both with and without multiple imputations in the IGDS).

RESULTS

The estimated prevalence of IGD among 12- to 25-year-olds in Germany is 5.7% (95% confidence interval: [4.5; 6.9]). In a sensitivity analysis taking multiple imputations into account, this value rose to 7.0% [5.8; 8.5]. The estimated prevalence was higher in males than in females: 8.4% [6.4; 10.4] versus 2.9% [1.7; 4.1], p<0.001. Statistically significant associations with IGD were seen for male sex, lower age, higher depressiveness, higher anxiety, and more frequent neglect of social contacts due to computer games.

CONCLUSION

In view of the IGD prevalence estimates obtained in this study, further research on this disorder, its correlates, and its etiology is warranted, particularly longitudinal studies. Young persons with the psychosocial features mentioned above should be specifically asked about their use of computer games.

Psychometric assessment of the Internet Gaming Disorder diagnostic criteria: An Item Response Theory study

Internet Gaming Disorder (IGD) has been recognized by the American Psychiatric Association (APA) as a tentative disorder in the latest fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In order to advance research on IGD, the APA has suggested that further research on the nine IGD criteria to investigate its clinical and empirical feasibility is necessary. The aim of the present study was to develop the Polish the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) and scrutinize the nine IGD criteria empirically. To achieve this, the newly developed IGDS9-SF was examined using a wide range of psychometric methods, including a polytomous Item Response Theory (IRT) analysis to evaluate the measurement performance of the nine IGD criteria. A sample of 3377 gamers (82.7% male, mean age 20 years, SD = 4.3 years) was recruited online for the present study. Overall, the findings obtained confirmed that suitability of the Polish IGDS9-SF to assess IGD amongst Polish gamers given the adequate levels of validity and reliability found. The IRT analysis revealed that the IGDS9-SF is a suitable tool to measure IGD levels above the average; however, criteria “continuation” (item 6), “deception” (item 7), and “escape” (item 8) presented with poor fit. Taken together, these results suggest that some of the diagnostic criteria may present with a different clinical weighting towards final diagnosis of IGD. The implications of these findings are further discussed.

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The APA diagnostic criteria for IGD was investigated in a large sample of gamers.

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The construct of IGD was examined via validity analysis and Item Response Theory.

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The results revealed the suitability of the IGDS9-SF to assess IGD-related symptoms.

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Each IGD criterion present with distinct clinical diagnostic weighting.

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The nine IGD criteria need to take into account different clinical weighting.

Association between Internet Gaming Disorder or Pathological Video-Game Use and Comorbid Psychopathology: A Comprehensive Review

The addictive use of video games is recognized as a problem with clinical relevance and is included in international diagnostic manuals and classifications of diseases. The association between "Internet addiction" and mental health has been well documented across a range of investigations. However, a major drawback of these studies is that no controls have been placed on the type of Internet use investigated. The aim of this study is to review systematically the current literature in order to explore the association between Internet Gaming Disorder (IGD) and psychopathology. An electronic literature search was conducted using PubMed, PsychINFO, ScienceDirect, Web of Science and Google Scholar (r.n. CRD42018082398). The effect sizes for the observed correlations were identified or computed. Twenty-four articles met the eligibility criteria. The studies included comprised 21 cross-sectional and three prospective designs. Most of the research was conducted in Europe. The significant correlations reported comprised: 92% between IGD and anxiety, 89% with depression, 85% with symptoms of attention deficit hyperactivity disorder (ADHD), and 75% with social phobia/anxiety and obsessive-compulsive symptoms. Most of the studies reported higher rates of IGD in males. The lack of longitudinal studies and the contradictory results obtained prevent detection of the directionality of the associations and, furthermore, show the complex relationship between both phenomena.