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

Gaming motivations and gaming disorder symptoms: A systematic review and meta-analysis

BACKGROUND AND AIMS

The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms. Specifically, to (1) explore what gaming motivation questionnaires and classifications are used in studies on gaming disorder symptoms and (2) investigate the relationship between motivational factors and symptoms of gaming disorder.

METHOD

An electronic database search was conducted via EBSCO (MEDLINE and PsycINFO) and the Web of Science Core Collection. All studies using validated measurements on gaming disorder symptoms and gaming motivations and available correlation coefficients of the relationship between gaming disorder and gaming motivations were included. The meta-analyses were conducted using a random-effects model.

RESULTS

In total, 49 studies (k = 58 independent sub-samples), including 51,440 participants, out of which 46 studies (k = 55 sub-samples, n = 49,192 participants) provided data for the meta-analysis. The synthesis identified fourteen different gaming motivation instruments, seven unique motivation models, and 26 motivational factors. The meta-analysis showed statistically significant associations between gaming disorder symptoms and 23 out of 26 motivational factors, with the majority of the pooled mean effect sizes ranging from small to moderate. Moreover, large heterogeneity was observed, and the calculated prediction intervals indicated substantial variation in effects across populations and settings. Motivations related to emotional escape were robustly associated with gaming disorder symptoms.

DISCUSSION AND CONCLUSIONS

The present meta-analysis reinforces the importance of motivational factors in understanding problematic gaming behavior. The analysis showed significant heterogeneity in most outcomes, warranting further investigation.

REGISTRATION DETAIL

PROSPERO (CRD42020220050).

Prevalence and comorbidity in a Swedish adolescent community sample - gambling, gaming, substance use, and other psychiatric disorders

BACKGROUND

This study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity.

METHODS

We used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls), out of which 758 adolescents (57.0% girls) were selected for interview with at least one of four instruments: M.I.N.I., ADDIS, NODS and IGDS. Of these, 387 (61.2% girls) were interviewed. Gender separated prevalence was estimated on the assumption that those selected but not interviewed had the same distribution as those interviewed based on similar outcomes above screening cut-offs. Comorbidity between types of disorders was estimated on similar assumptions. In addition, comorbidity between dyads of the ten most common specified disorders was calculated based on recorded data without these assumptions.

RESULTS

We estimated that 14.6% met the criteria of a substance use disorder (SUD), mostly concerning alcohol and more frequent in girls than in boys. Those meeting the criteria lifetime of at least one of 16 other psychiatric disorders were 26.7%, more than twice as frequent in girls compared to boys, and with depression being the most common disorder. Gambling and gaming disorders were found almost exclusively in boys, of which 5.8% met the criteria for gambling, and 2.3% for gaming disorders. Of girls with a SUD, 40% also had a psychiatric disorder, while on the other hand more than 28% of girls with a psychiatric disorder also had a SUD. In boys with a SUD, 22% had another psychiatric disorder, while 15% of those with a psychiatric disorder also had a SUD.

CONCLUSIONS

Psychiatric comorbidity is common in SUDs in adolescents, which calls for screening and diagnostic efforts in young patients presenting with symptoms of SUDs. Girls with SUDs are at higher risk of also suffering from psychiatric conditions. Gambling and gaming disorders appear in a substantial minority of adolescents and warrant further study of their comorbidity. Since prevalences and comorbidity were estimated on the assumptions mentioned, some caution in interpreting the results is needed.

Technological Addictions

PURPOSE OF REVIEW

Modern methods of communication and engagement, such as social media, video games, and online shopping, use a variety of behavioral techniques to encourage and reward frequent use, opening the door to addiction. The technological addictions (TAs) are a set of disorders that accompany the technological advances that define the digital age. The TAs are an active source of research in the literature, with promising treatment options already available.

RECENT FINDINGS

There are promising therapeutic and psychopharmacologic treatments for a broad range of TAs. Stimulants, antidepressants, and cognitive therapies may all be effective for internet gaming disorder (IGD). Cognitive therapies may be effective for other TAs, such as social media addiction (SMA), online shopping addiction (OSA), and online porn addiction. Society's dependence on addictive technologies will only increase. Many of the TAs can be addressed with medication and therapy, with more research and literature developing at a rapid pace.

Game-related behaviors among children and adolescents after school closure during the COVID-19 pandemic: A cross-sectional study

Aim

Increased exposure to digital gaming content among youth in recent years has raised serious health concerns. Social restrictions such as school closures, imposed worldwide because of the ongoing COVID-19 pandemic, may increase exposure to gaming and lead to addictive gaming behavior in young people. In this study, we investigated gaming behaviors among Japanese students during COVID-19 school closures.

Methods

Students completed questionnaires regarding their living conditions, game-related behaviors, diagnosis of Internet addiction, psychological difficulties, and the impact of the COVID-19 pandemic. We compared differences between the responses of potentially at risk for gaming disorder (potentially at risk for gaming disorder; defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder [PGD]) students who met the criteria for a diagnosis of gaming disorder in ICD-11 MMS and those of control students. Logistic regression analysis was performed to predict the extent of factors contributing to potential gaming disorder.

Results

Four thousand and forty-eight participants completed the survey. Compared with control students (93%), potentially at risk for gaming disorder (defined in this paper with reference to the ICD-11 MMS criteria for gaming disorder, PGD) students (7%) reported playing games for longer times, spending more money on in-game purchases, were of younger age at the start of game playing, showed a tendency toward Internet dependence, practised school avoidance or absenteeism, and demonstrated the need for psychological support. Moreover, participants in the PGD group reported more anxiety about COVID-19 than control participants, as well as an increase in game-playing time and amount of money spent on games during the COVID-19 pandemic.

Conclusion

These results indicate that young people classified as having a gaming disorder not only exhibit characteristic game-related behaviors but may be psychologically and socially vulnerable and need special support, especially during the ongoing COVID-19 pandemic.

Alexithymia and internet gaming disorder in the light of depression: A cross-sectional clinical study

BACKGROUND

Social and emotional deficits are assumed to be involved in the development and maintenance of internet gaming disorder (IGD). Alexithymia refers to a personality construct, which is characterized by deficits in emotional awareness and processing. The constructs of alexithymia and depression share similarities, and depression is a common comorbidity of IGD patients. The aim of this study was to analyze the relationship between alexithymia and IGD when controlling for depression symptom severity. Moreover, we compared alexithymia traits of IGD patients with those of non-pathological video gamers.

METHODS

In a cross-sectional study n = 38 male IGD patients (EG) were recruited at specialized healthcare services in Germany. In addition, n = 39 male non-pathological video gamers (CG) were recruited via social media and bulletin board announcement. Both groups completed questionnaires measuring alexithymia (TAS-20), depression symptom severity (BDI) and IGD severity (s-IAT).

RESULTS

Alexithymia and depression symptom severity both predicted IGD severity. Yet, when including both factors in multiple regression analysis, only alexithymia predicted IGD severity. The prevalence of alexithymia in the EG was 34.2 % (n = 13). None of the non-pathological video gamers scored above the cut-off indicating alexithymia. IGD patients showed higher traits of alexithymia in general and on each subscale, irrespective of whether or not they were currently consuming video games. As previously observed, depression symptom severity was significantly greater in IGD patients compared to healthy video gamers. Yet, group differences in alexithymia traits remained stable, with a ~29 % decrease of effectiveness in the relationship, when controlling for depression symptom severity and sociodemographic factors.

CONCLUSION

The results reveal that alexithymia is associated with and predicts IGD severity independently of depression symptom severity. Moreover, alexithymia is highly prevalent in IGD patients.

Internet use and internet-based addictive behaviours during coronavirus pandemic

PURPOSE OF REVIEW

The COVID-19 outbreak profoundly influenced human lives on different levels. This narrative review aims to present recent data relating to the COVID-19 pandemic and internet use and internet-based addictive behaviours [problematic Internet use (PIU), Internet addiction, Internet gaming disorder, problem gambling or gambling disorder, social media addiction including smartphone use disorder, problematic pornography use, and compulsive buying].

RECENT FINDINGS

During the COVID-19 pandemic, the prevalence of Internet use and Internet-based addictive behaviours increased in all age groups. The COVID-19 pandemic and related containment measures were been associated with increased levels of stress, anxiety, and depression in the general population, especially among children and adolescents, which are the vulnerable groups for the development of mental disorders during the crisis. Furthermore, the fear resulting from the disease, the 'lockdown' measures, high levels of uncertainty regarding the future, and financial insecurity increased levels of loneliness, PIU, and Internet addiction.

SUMMARY

Longitudinal researches focused on the negative impacts of Internet use in prolonged stress situations on mental health, vulnerable groups, and quality of life (QoL) are needed to help clinicians and policymakers to reduce adverse consequences. Prevention programs for Internet use and Internet-based addictive behaviours must be customized to meet the needs of children, adolescents, and adults. Also, treatment programs must be tailored to the needs of patients with different Internet-based addictions.

Technological Addictions

Modern technology rewards constant engagement and discourages sparing use, opening the door to unhealthy use and even addiction. The technological addictions (TAs) are a newly described set of disorders that come with the technological advances that define the new era. Internet gaming disorder (IGD) is already codified as a proposed diagnosis in the 5th Edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association. Others, such as social media addiction (SMA), are in the earlier stages of our understanding. This article provides an overview of the more common TAs including their evaluation and treatment techniques.

DNA Directed Pro-Dopamine Regulation Coupling Subluxation Repair, H-Wave® and Other Neurobiologically Based Modalities to Address Complexities of Chronic Pain in a Female Diagnosed with Reward Deficiency Syndrome (RDS): Emergence of Induction of “Dopamine Homeostasis” in the Face of the Opioid Crisis

Addiction is a complex multifactorial condition. Established genetic factors can provide clear guidance in assessing the risk of addiction to substances and behaviors. Chronic stress can accumulate, forming difficult to recognize addiction patterns from both genetic and epigenetic (environmental) factors. Furthermore, psychological/physical/chemical stressors are typically categorized linearly, delaying identification and treatment. The patient in this case report is a Caucasian female, aged 36, who presented with chronic pain and partial disability following a surgically repaired trimalleolar fracture. The patient had a history of unresolved attention deficit disorder and an MRI scan of her brain revealed atrophy and functional asymmetry. In 2018, the patient entered the Bajaj Chiropractic Clinic, where initial treatment focused on re-establishing integrity of the spine and lower extremity biomechanics and graduated into cognitive behavior stabilization assisted by DNA pro-dopamine regulation guided by Genetic Addiction Risk Severity testing. During treatment (2018–2021), progress achieved included: improved cognitive clarity, focus, sleep, anxiety, and emotional stability in addition to pain reduction (75%); elimination of powerful analgesics; and reduced intake of previously unaddressed alcoholism. To help reduce hedonic addictive behaviors and pain, coupling of H-Wave with corrective chiropractic care seems prudent. We emphasize the importance of genetic assessment along with attempts at inducing required dopaminergic homeostasis via precision KB220PAM. It is hypothesized that from preventive care models, a new standard is emerging including self-awareness and accountability for reward deficiency as a function of hypodopaminergia. This case study documents the progression of a patient dealing with the complexities of an injury, pain management, cognitive impairment, anxiety, depression, and the application of universal health principles towards correction versus palliative care.

Excessive Gaming and Online Energy-Drink Marketing Exposure Associated with Energy-Drink Consumption among Adolescents

In this study, we examined excessive online gaming by adolescents and the resultant effects of their exposure to the online marketing of energy drinks and alcohol, and whether marketing literacy could serve as a mitigating factor. This cross-sectional study was conducted in 2020. Data were obtained from a sample of 2613 seventh-grade students from 30 middle schools in Taiwan. A self-administered questionnaire was conducted. The results showed that nearly 18% of the adolescent respondents had used energy drinks, while 75% reported seeing energy-drink advertisements on the internet in the past year. Multiple regression results indicated that factors such as being male, reporting excessive gaming, being exposed to higher levels of online energy-drink marketing, and reporting alcohol use were positively associated with energy-drink consumption. A higher level of online energy-drink marketing-affective literacy, however, was negatively associated with energy-drink consumption. In conclusion, factors that predicted energy-drink consumption among adolescents included excessive gaming and exposure to online energy-drink marketing, but marketing-affective literacy tended to lessen the impact of such advertising.

The Relationship between Depressive Symptoms, Loneliness, Self-Control, and Gaming Disorder among Polish Male and Female Gamers: The Indirect Effects of Gaming Motives

The present study analyzed the relationship between gaming disorder (GD), motives for gaming, and psychological problems in daily life (i.e., depression, loneliness, and self-control deficits) among Polish gamers. More specifically, the purpose of the present study was to analyze the indirect effects between GD and psychological problems in daily life via motives for gaming among male and female gamers. Additionally, the present study examined gender differences in motives for gaming and the relationship between the analyzed variables. The sample comprised 652 gamers (233 females; M = 28.77 years; SD = 7.18; age range: 18-48 years). The nine-item Internet Gaming Disorder Scale-Short Version (IGDS9-SF) was used to assess GD. The motives for gaming were assessed using the Motives for Online Gaming Questionnaire (MOGQ). The nine-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms, and the Brief Self-Control Scale (BSCS) was used to assess self-control. Loneliness was assessed using the De Jong Gierveld Loneliness Scale. In order to examine the relationship between the study variables, path analysis and indirect effects analysis were performed among both male and female gamers. The present study showed that depressive symptoms and self-control exerted a significant indirect effect on GD via escape and fantasy motives for gaming. Additionally, there was an indirect effect between depressive symptoms and GD via social motives for gaming. However, these indirect effects were found among male gamers only. The present study also showed gender differences in all analyzed gaming motives except escape (males scoring higher on all of them) and in the relationship between depressive symptoms and escape. These findings contribute to a better understanding of GD development mechanisms, which are associated with psychological problems in daily life.

Relationship between time spent playing internet gaming apps and behavioral problems, sleep problems, alexithymia, and emotion dysregulations in children: a multicentre study

BACKGROUND

Internet gaming addiction (IGA) is a serious condition that can significantly impact personal and social functioning. Many studies of IGA have been conducted in adolescents and young adults, but there are limited data available in children. We investigated the time spent using internet gaming apps in children and its association with behavioral problems, sleep problems, alexithymia, and emotional regulation.

METHODS

The research populations (N = 564) were categorized based on the number of hours spent using online gaming applications. The Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire Abbreviated, the Children's Alexithymia Measure (CAM), and the Clinical Evaluation of Emotional Regulation-9 were used to assess all participants.

RESULTS

Compared to other groups, children who used internet gaming applications for more than 6 h had a higher proportion of abnormal responses on the emotional symptoms and hyperactivity scales. Children who used internet gaming applications for more than 6 h had the poorest sleep quality (75%), while children who used internet gaming applications for 1-2 h had the best (36.7%). Participants who used internet gaming apps for 1-2 h had significantly lower mean total scores on the emotional regulation scale and total CAM, whereas those using internet gaming apps for more than 6 h had the highest mean scores in the CAM.

CONCLUSIONS

Excessive use of internet gaming apps during childhood may be associated with hyperactivity, peer problems, high socioeconomic level, alexithymia concerns, shorter daytime sleep duration, and a delayed morning wake-up.

Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review

We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4-38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD.

Psychometric properties of the Farsi version of the gaming disorder scale for adolescents (GADIS-A)

BACKGROUND

Gaming disorder was added to the 11th version of the international classification of disease by the world health organization in early 2019. Adolescents are the most vulnerable group in this area. Thus, a screening tool for this age range is essential. This study aims to examine the psychometric properties of the gaming disorder scale for adolescents (GADIS-A) in an Iranian male sample.

METHODS

260 male students-7th to 12th grade-from Isfahan city in the academic year 2020-2021 were selected using convenience sampling. The participants responded to the Farsi version of the GADIS-A and problematic online game questionnaire (POGQ). Thirty participants answered the scale again to assess the validity of the retest. Pearson's correlation analysis, Cronbach's alpha, and confirmatory factor analysis were used. The data were analyzed by SPSS version 24 and R software packages psych and lavaan.

RESULTS

Confirmatory factor analysis revealed that the two-factor model, which included cognitive-behavioral symptoms and negative consequences, had good fitness indices. The GADIS-A convergent validity is confirmed by the scale's significant correlation with the POGQ. Cronbach's alpha coefficient was used to determine the scale's validity, which was 0.85 for the full scale and 0.70 and 0.75 for two factors. The validity of the retest after two weeks also showed a correlation of 0.88.

CONCLUSION

The Farsi version of the gaming disorder scale for adolescents has a two-factor structure and is valid for use in Iran.

Current Status of Internet Gaming Disorder (IGD) in Japan: New Lifestyle-Related Disease in Children and Adolescents

The World Health Organization recognizes internet gaming disorder (IGD) as a disorder that causes problems in daily life as a result of excessive interest in online games. The causes of IGD have become more apparent in recent years. Because of prolonged exposure to games, the mechanisms controlling the reward system, such as the prefrontal cortex, limbic system, and amygdala of the cerebrum, do not function properly in IGD. This mechanism is similar to that of various behavioral addictions, such as gambling addiction. IGD is particularly risky in children and adolescents because it easily causes brain dysfunction, especially in the developing brain. IGD should be regarded as a new lifestyle-related disease in younger individuals, and lifestyle modifications, including counseling and family therapy, are critical for its management.

Resource-Strengthening Training for Parents of Adolescents with Problematic Gaming (Res@t-P): A Clinical Pilot Study

Background: Problematic gaming (PG) has become an increasing mental health issue among adolescents during the preceding years. The role of parents and the family environment in the development of PG has been repeatedly emphasized. However, the structured involvement of parents in the therapy is still largely insufficient. Resource-strengthening training for parents of adolescents with PG (Res@t-P) is a new parent-centered 8-week group intervention to fill this substantial gap. The present pilot study aimed to collect first information on its potential effectiveness in improving parental and family factors. Methods: The study was conducted in a clinical setting with N = 43 parents of adolescents with PG, applying a pre- and post-follow-up design. Standardized questionnaires on psychological stress perception, family communication, family functioning, media rules, and adolescent PG symptoms were applied at three measurement points (before, at the end of, and 6 weeks after the training). Conditional growth models were estimated. Results: Over time, an improvement in parental and family aspects as well as a reduction in adolescent PG symptoms could be observed. Conclusions: The results of the present pilot study on the effectiveness of Res@t-P are promising. No causal inferences can be drawn at this stage. A randomized-controlled intervention study is highly warranted.

Pharmacological interventions for Problematic Usage of the Internet (PUI): A narrative review of current progress and future directions

Problematic Usage of the Internet (PUI) represents a spectrum of excessive online behaviors and is linked to reduced quality of life and high rates of psychiatric comorbidity, with growing demand for effective treatments. This paper provides a narrative review of pharmacological studies for PUI conducted to date. Most pharmacological treatment trials have focused on bupropion and escitalopram or involved samples with common comorbidities and used current treatments for the relevant comorbid disorders. Overall, there remains a dearth of high-quality evidence, with the current literature lacking control groups, large sample sizes, validated outcome measures, longer term treatment and follow-up periods. The literature cannot at this stage determine evidence-based pharmacological treatments for PUI.

Response to the Regulation of Video Games under the Youth Media Protection Act: A Public Health Perspective

The Swiss Youth and Media Act, which is about to enter into force, is an attempt to provide a legislative framework for video game use. Among other inclusions, the law intends to make providers more accountable by taking measures to protect minors from harm that can be caused by improper use of video games. However, it is a challenge to create a legal framework that can adequately regulate the evolving features of video games. Legislators must find a suitable regulatory approach which takes into account the fact that there is an increasing convergence between video games and gambling, particularly with the introduction of loot boxes. Moreover, there is a need for regulation, including the prohibition of misleading designs, the introduction of additional protection for minors, and the assurance of transparency of transactions. Appropriate policy legislation and consumer-protection measures are needed to protect people using these types of products, particularly children and adolescents. Further work should focus on assessing game characteristics to refine regulatory models to promote safe gaming. Based on experiences from the field of psychoactive substances as well as that of gambling, it is now a matter of developing a matrix of harm with elaborated categories: a tool that makes it possible to evaluate the potential harms of certain game design in an evidence-based manner.

Item Response Theory Analyses of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Criteria Adapted to Screen Use Disorder: Exploratory Survey

Background

Screen use is part of daily life worldwide and morbidity related to excess use of screens has been reported. Some use of screens in excess could indicate a screen use disorder (ScUD). An integrative approach to ScUD could better fit the polymodal reality of screens, and concurrent problems with screens, than a split approach, activity by activity. In that paradigm, a pragmatic and operationalized approach to study a potential ScUD requires the use of common criteria, for all screens and activities done on screens, in a single questionnaire.

Objective

Our goals were (1) to describe screen uses in a general population sample and (2) to test the unidimensionality, local independence, and psychometric properties of the 9 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) internet gaming disorder (IGD) criteria adapted to screen use in a community sample. We hypothesized that the 9 DSM-5 IGD criteria adapted to ScUD would show unidimensionality, local independence, and good discrimination, with criteria distributed on the severity continuum.

Methods

This cross-sectional survey in a French suburban city targeted adults and adolescents. A self-administered questionnaire covered the main types of screens used and their use for various activities in the past month. Presence of ScUD diagnostic criteria in past 12 months was also self-evaluated in the questionnaire. Factor and 2-parameter Item Response Theory analysis were used to investigate the dimensionality, local independence, and psychometric properties of the ScUD criteria.

Results

Among the 300 participants, 171 (57.0%) were female (mean age 27 years), 297 (99.0%) used screens, 134 (44.7%) reported at least one criterion (potential problem users), and 5 (1.7%) reported 5 or more criteria and endorsed an ScUD. The most endorsed criteria were loss of control (60/300, 20.0%) and preoccupation (52/300, 17.3%). Screen types used and screen activities differed between participants with no ScUD criteria and those with at least one ScUD criterion. The latter were more likely to have a computer as the most used screen type, and more video gaming, communication/social network, and watching news and research of information as activities. Unidimensionality was confirmed by all fit indices. Local independence was confirmed by the absence of residual correlation between the items. Criteria had relatively high factor loading, with loss of interest in other recreational activities having the highest. However, criteria with the lowest factor loading all remained above the cut-offs, sanctioning unidimensionality. Most discriminating criteria were loss of interests, preoccupation, deceive/cover up, and risk/lose relationship/opportunities, which also provided the most information on the measurement of the latent trait.

Conclusions

We described screen uses in a French community sample and have shown that the adaptation of the DSM-5 IGD to “ScUD” has good psychometric validity and is discriminating, confirming our hypothesis. We suggest to use those criteria to assess potential “ScUD.” Further studies should determine if all criteria are needed and whether others should be added.

Prevalence and factors associated with Internet gaming disorder among adolescents in Saudi Arabia: A cross-sectional study

This study aimed to assess the prevalence of internet gaming disorder (IGD) and its associated factors among a sample of adolescents in the Faifa governorate in the south of Saudi Arabia. This was a cross-sectional study targeting intermediate and secondary school adolescent students in the Faifa governorate. Multistage sampling was performed to reach the required sample, where 9 schools were randomly selected, followed by the distribution of the questionnaire to all students at all levels. IGD was assessed using a validated Arabic version of the 20-item IGD scale. A chi-square test was used to evaluate the presence of statistical differences between sample demographic data and IGD. Four hundred and fifty students participated in the current study, where 132 (29.3%) of them were classified as having IGD. The prevalence of IGD was associated with gender, year of study, maternal education status, and the number of hours spent online and playing with friends (P values 0.05). Analysis of the IDG items among the current sample indicated that most were at the conflict stage of IGD. The IGD level identified in our sample is high compared to the published literature. Faifa is a mountainous region and, due to its geographical nature, there are limited public entertainment areas. Adolescents tend to spend more time at home, where they may be more exposed to IGD. This suggests the need for strategies to ensure early identification of those at risk of IGD and to provide preventive and treatment options for these students.

Exploring Internet gaming disorder: an updated perspective of empirical evidence (from 2016 to 2021)

BACKGROUND AND AIMS

Since the acceptance of Internet gaming disorder (IGD) as a "disorder due to addictive behaviors", research has proliferated exponentially. The present review focuses on the conceptualization of IGD, its diagnosis and assessment, associated factors and existing prevention and treatment plans to address it.

RESULTS AND CONCLUSIONS

The discrepancies between the diagnostic criteria for IGD proposed by the two central diagnostic entities, as well as the questioning of their clinical validity, have generated multiple proposals for the diagnosis and psychometric evaluation of IGD. Likewise, there have been numerous suggestions to prevent this pathology, with the involvement of governments, the gaming industry and health institutions. Finally, multiple treatment plans have been proposed, both pharmacological and psychological, although only the efficacy of cognitive behavioral therapy has been tested. It is essential, therefore, to delve deeper into this disorder by addressing the central limitations of the current literature.

The Spanish Version of the Video Game Functional Assessment-Revised

It is estimated that 16.8 million in Spain (41% female) are involved in gaming, and approximately 8.3% of Spanish gamers are problematic gamers (i.e., endorsing five or more of the nine criteria for Internet Gaming Disorder [IGD]). Given the high prevalence of IGD in Spain, this study evaluated construct validity and concurrent validity of the Spanish Version of the Video Game Functional Assessment-Revised (SP-VGFA-R), by examining the correlational coefficients with the nine-item Internet Gaming Disorder Scale-Short-Form (IGDS9-SF). A total of 434 adults 18 years of age or older participated in the study (15.1% female). Results showed that the SP-VGFA-R was positively and significantly associated with the IGDS9-SF (bivariate coefficients ranging from 0.411 to 0.610). Four distinct factors in the SP-VGFA-R were identified in confirmatory factor analysis, including (a) social attention, (b) tangible/intangible rewards, (c) escape/avoidance of demands or pain, and (d) sensory stimulation. Other findings showed that IGDS9-SF scores increased as (a) the escape/avoidance of demands or pain function increased and (b) two or more function scores increased. The SP-VGFA-R can be used in combination with the IGDS9-SF to assess Spanish gamers with IGD internationally, and to develop evidence-based behavioral interventions.

The Relationship Between Early Maladaptive Schemas, Depression, Anxiety and Problematic Video Gaming Among Female and Male Gamers

The present study investigated the relationship between problematic video gaming (PVG) and early maladaptive schemas (EMSs) among male and female gamers. Additionally, the present study investigated depression and anxiety as mediators in the relationship between EMSs and PVG. The study comprised 673 videogame players (391 female gamers) aged from 18 to 38 years. PVG was assessed using the nine-item Internet Gaming Disorder Scale-Short-Form (IGDS9-SF). Depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). EMS dimensions were assessed using the Young Schema Questionnaire (YSQ-S3). Results suggested that EMSs such as practical incompetence/dependence were positively related to PVG. The findings showed gender differences in these relationships. The vulnerability to harm or illness, enmeshment and subjugation schemas were positively related to PVG among male gamers. However, depression and anxiety did not mediate the relationship between EMSs and PVG. These findings may contribute to a better understanding of mechanisms related to PVG development, which are associated with maladaptive schemas.

Supplementary Information

The online version contains supplementary materials available at 10.1007/s11469-022-00858-2.

Is Problematic Internet and Smartphone Use Related to Poorer Quality of Life? A Systematic Review of Available Evidence and Assessment Strategies

Purpose of Review

Previous studies have explored the links between problematic Internet use (PIU) or problematic smartphone use (PSU) and quality of life (QOL). In this systematic review, we (i) describe the instruments used to assess QOL or health-related quality of life (HRQOL) in these studies, (ii) critically examine the content validity of the instruments used, and (iii) examine the relationships between PIU, PSU, QOL, and HRQOL.

Recent Findings

We identified 17 PIU and 11 PSU studies in a systematic search. Evidence suggests that PIU and PSU negatively correlate with either QOL or HQOL and most of their domains (especially mental and physical health). Multiple instruments were used to assess QOL or HRQOL in these studies. Our analysis showed an important heterogeneity in the domains covered by these instruments.

Summary

Because of the widespread prevalence of PIU and PSU, which tend to be linked with lower QOL or HRQOL, in particular poor mental and physical health, a more systematic public health campaign is required to target the healthy use of these communication devices. Prevention programs should also target vulnerable individuals, focusing on the most affected domains of QOL and HRQOL (i.e., physical and psychological health). Among the existing instruments, the World Health Organization Quality of Life for adults and the Pediatric Quality of Life Inventory for adolescents (aged 13-18 years) proved to be the most relevant, although new measurement instruments are needed to target domains that are specifically relevant in the context of PIU and PSU (e.g., physical and psychological health domains such as sleep, loneliness, and quality of familial relations).

A network analysis of the Internet Disorder Scale-Short Form (IDS9-SF): A large-scale cross-cultural study in Iran, Pakistan, and Bangladesh

The Internet Disorder Scale-Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03284-8.

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.

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review

During the initial phases of the COVID-19 pandemic, playing video games has been much more than just a pastime. Studies suggested that video games for many individuals have helped to cope with such difficult life experience. However, other research indicates that gaming may have had harmful effects. Within this context, this systematic review aimed to describe the literature on the effects of video games during the early stages of the COVID-19 crisis on stress, anxiety, depression, loneliness, and gaming disorder (GD), examining the study characteristics and outcomes. A systematic search of the literature was made following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202180053. The search databases were PsycINFO, Web of Science, and Medline. The search string was: [("video game*") OR ("computer game*") OR ("gaming")] AND [("COVID-19")]. Twenty-four studies met the inclusion criteria. Four research explored the effects of playing video games during the COVID-19 pandemic on stress, anxiety, and depression. Four studies investigated loneliness, while 18 research investigated game disorder. Video games, especially augmented reality and online multiplayer ones, mitigated stress, anxiety, depression, and loneliness among adolescents and young adults during stay-at-home restrictions. However, in the case of at-risk individuals (i.e., particularly male youths), playing video games had detrimental effects.

Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder

Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.

Can internet use become addictive?

Problematic internet use parallels drug addiction, but the mechanisms are not yet clear.

Analysis of the coexistence of gaming and viewing activities in Twitch users and their relationship with pathological gaming: a multilayer perceptron approach

The enormous expansion of the video game sector, driven by the emergence of live video game streaming platforms and the professionalisation of this hobby through e-sports, has spurred interest in research on the relationships with potential adverse effects derived from cumulative use. This study explores the co-occurrence of the consumption and viewing of video games, based on an analysis of the motivations for using these services, the perceived positive uses, and the gamer profile. To that end, a multilayer perceptron artificial neural network is developed and tested on a sample of 970 video game users. The results show that the variables with a significant influence on pathological gaming are the motivation of a sense of belonging to the different platforms, as well as the positive uses relating to making friends and the possibility of making this hobby a profession. Furthermore, the individual effects of each of the variables have been estimated. The results indicate that the social component linked to the positive perception of making new friends and the self-perceived level as a gamer have been identified as possible predictors, when it comes to a clinical assessment of the adverse effects. Conversely, the variables age and following specific streamers are found to play a role in reducing potential negative effects.

Parental Depression and Leisure Activity Engagement on Children's Gaming Disorder: A Dyadic Study

Nowadays, playing both online and offline video games is a popular leisure activity among youngsters, but excessive gaming activity engagement may lead to gaming disorder that disrupts daily functioning. Identifying risk and protective factors of this emerging problem is thus essential for devising prevention and intervention strategies. This mixed-method, cross-sectional study aimed to examine the roles of parental depressive symptoms and children’s leisure activity engagement on children’s gaming disorder symptoms. Furthermore, the moderating roles of risky and protective leisure activity engagement were investigated. The sample comprised 104 parent-child dyads recruited from a population-based survey (parents: M_age = 45.59 years, SD = 6.70; children: M_age = 11.26 years; SD = 4.12). As predicted, parental depressive symptoms and children’s gaming activity engagement were positively associated with children’s gaming disorder symptoms, whereas children’s literacy activity engagement was negatively associated with these symptoms. Moreover, engagement in these two types of leisure activity moderated the association between parental depressive symptoms and children’s gaming disorder symptoms in distinct manners, further indicating literacy activities as beneficial and gaming activities as risk-enhancing. These new findings imply that parental depressive symptoms and children’s leisure activity engagement should be considered when designing parent-based programs for gaming disorder prevention and intervention.

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.

Internet Gaming Disorder: Evidence for a Risk and Resilience Approach

Although previous research has noted a range of factors that predict developing Problematic Video Game Use (PVGU) and Internet Gaming Disorder (IGD), few studies have looked at risk and protective factors together, and there is scant empirical evidence examining whether risk for PVGU or IGD increases or decreases as risk or protective factors accumulate in the individual. The aim of the current study was to examine both issues using predictors from three demonstrated PVGU and IGD risk categories: executive dysfunction, unmet needs in everyday life, and unhelpful family environment. In a survey of N = 866 12–17-year-old school students, the risk/protective factors that most strongly predicted severity of IGD symptomology and meeting IGD diagnostic criteria were self-control and social exclusion. Other significant predictors included impulsivity, self-esteem, mastery, control of one’s external environment, and better parent-child attachment quality. Trend analyses revealed a linear increase in the risk of PVGU as risk and net-risk factors accumulated, and a decrease as protective and net-protective factors accumulated. Thus, a net accumulation of issues around impulse control and unmet needs in everyday life may predispose adolescents to PVGU or IGD. Results support a ‘risk and resilience’ approach to adolescent screen-based disorders and suggest potential benefits to a risk factor focus in treatment.

Exploring subtypes and correlates of internet gaming disorder severity among adolescents during COVID-19 in China: A latent class analysis

The WHO recently included Gaming Disorder as a psychiatric diagnosis. Whether there are distinct groups of adolescents who differ based on severity of gaming disorder and their relationships with other mental health and addictive behavior outcomes, including problematic smartphone use (PSU), remains unclear. The current study explored and identified subtypes of Internet Gaming Disorder (IGD) severity and estimated the association between these subtypes and other disorders. Participants completed online questionnaires assessing the severity of IGD, PSU, depression, and anxiety during COVID-19. We conducted a latent class analysis of IGD symptoms among 1,305 Chinese adolescents (mean age = 15.2; male = 58.5%) from 11 secondary schools in Macao (SAR), China. Multinomial logistic regression estimated correlates of latent class membership and PSU. A 4-class model adequately described the sample subgroups. Classes were labeled as normative gamers (30.9%), occasional gamers (42.4%), problematic gamers (22.7%), and addictive gamers (4.1%). Relative to normative gamers, PSU severity, depression, and being male were significantly higher among problematic gamers, addictive gamers, and occasional gamers. Only problematic gamers showed significant positive associations with anxiety severity compared to the other groups. The study revealed the differences in severity of gaming disorder and its association with psychopathology outcomes. Application in screening for IGD and comorbidity is discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03133-8.

Maladaptive Daydreaming: Epidemiological Data on a Newly Identified Syndrome

Background

Maladaptive Daydreaming (MD) is a recently identified psychological disorder, characterized by excessively and addictively engaging in vivid, narrative, intensely emotional fantasy activity, at times with the aid of music and/or repetitive movements, causing distress and functional impairment. Over 100,000 self-diagnosed individuals are active online and thousands of them have been researched; yet there are no studies using clinical interviews on large, systematic general (non-MD) samples, to assess the estimated prevalence of this suggested disorder, and establish norms for its main psychometric tool.

Methods

Four independent Israeli samples (three student samples, and one sample representing the general Jewish-Israeli population; total N = 1,023) self-reported MD. In two samples, those exceeding the cutoff score for suspected MD were invited for a structured clinical interview.

Results

The skewness of most items of the 16-item Maladaptive Daydreaming Scale (MDS-16) supports the notion of MD as a binary construct rather than a normally distributed trait. In the community sample, 4.2% exceeded the cutoff for suspected MD. Rates were higher when focusing on the young adult age group or student samples (5.5-8.5%), suggesting a likely age effect. Following clinical interviews, only 60% of interviewed respondents met criteria for diagnosis, suggesting a true point-prevalence of 2.5% in the Israeli-Jewish population.

Conclusions

This is the first systematic clinical evaluation of the prevalence of MD. In an Israeli sample, a point-prevalence of 2.5% was found, like several other internalizing psychiatric syndromes. This result, along with the Non-normal nature of item distribution, both support the validity of MD as a psychological disorder, which should be considered as a potential addition to future psychiatric diagnostic manuals.

Gaming disorder and the COVID-19 pandemic: Treatment demand and service delivery challenges

Gaming activities have conferred numerous benefits during the COVID-19 pandemic. However, some individuals may be at greater risk of problem gaming due to disruption to adaptive routines, increased anxiety and/or depression, and social isolation. This paper presents a summary of 2019-2021 service data from specialist addiction centers in Germany, Switzerland, Japan, and the United Kingdom. Treatment demand for gaming disorder has exceeded service capacity during the pandemic, with significant service access issues. These data highlight the need for adaptability of gaming disorder services and greater resources and funding to respond effectively in future public health crises.

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.

Problem mobile gaming: The role of mobile gaming habits, context, and platform

Aims: Mobile gaming is a dominant form of gaming, known for its portability and for game characteristics that motivate continuous play and spending. Such involvement may also turn problematic, but research on problem gaming (PG) has tended to focus on non-mobile forms of gaming. The study was based on a cross-sectional observational design where students in upper secondary schools were recruited to a survey about mobile gaming. The age of the respondents ranged from 16 to 23 years (n = 519; 52.4% men; mean age = 17.2 years, SD = 1.1). Methods: We examined (1) gaming frequency, gaming contexts, and in-game spending in relation to PG; (2) gaming context in relation to academic achievement and sleep quality; and (3) PG according to gaming platform (i.e., playing on mobile, console/computer, or mixed platforms) with Kruskal−Wallis tests, chi-square tests and Spearman rank-order correlations. Results: PG was positively associated with mobile gaming hours per week (η² = .02, p < .01), minutes per session (η² = .03, p < .001), making in-app purchases (Cramer's V = .15, p < .05), and gaming during homework (Cramer's V = .14, p < .05). Statistically significant associations were found between mobile gaming in bed and later sleep midpoint for weekdays (r_s = .18, p < .001) and weekends (r_s = .11, p < .05). Mixed platform gamers had increased likelihood of PG, console/computer gamers had increased likelihood of being at risk for PG, and mobile gamers had lower risk for PG (Cramer's V = .18, p < .001). Conclusion: Future studies should include specific measures of mobile gaming as it appears implicated in problem gaming, albeit to a lesser degree than console and computer gaming.

Assessment of Criteria for Specific Internet-use Disorders (ACSID-11): Introduction of a new screening instrument capturing ICD-11 criteria for gaming disorder and other potential Internet-use disorders

Background and aims

With the inclusion of gaming disorder in the ICD-11, diagnostic criteria were introduced for this relatively new disorder. These criteria may also be applied to other potential specific Internet-use disorders, which may be classified in ICD-11 as other disorders due to addictive behaviors, such as online buying-shopping disorder, online pornography-use disorder, social-networks-use disorder, and online gambling disorder. Due to the heterogeneity in existing instruments, we aimed to develop a consistent and economic measure of major types of (potential) specific Internet-use disorders based on ICD-11 criteria for gaming disorder.

Methods

The new 11-item Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) measures five behavioral addictions with the same set of items by following the principles of WHO's ASSIST. The ACSID-11 was administered to active Internet users (N = 985) together with an adaptation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and screeners for mental health. We used Confirmatory Factor Analyses to analyze the factor structure of ACSID-11.

Results

The assumed four-factorial structure was confirmed and was superior to the unidimensional solution. This applied to gaming disorder and to the other specific Internet-use disorders. ACSID-11 scores correlated with IGDT-10 as well as with the measures of psychological distress.

Discussion and Conclusions

The ACSID-11 seems to be suitable for the consistent assessment of (potential) specific Internet-use disorders based on ICD-11 diagnostic criteria for gaming disorder. The ACSID-11 may be a useful and economic instrument for studying various behavioral addictions with the same items and improving comparability.

Animal Crossing and COVID-19: A Qualitative Study Examining How Video Games Satisfy Basic Psychological Needs During the Pandemic

The COVID-19 pandemic has affected the way many people live their lives. The increasing amount of time spent indoors and isolated during periods of lockdown has been accompanied by an increase in the time people spend playing video games. One such game which soared in popularity during the early stages of the pandemic was Animal Crossing: New Horizons. Through semi-structured interviews with players, and using a theory-informed qualitative analysis, we document and examine players’ motivations and experiences playing Animal Crossing: New Horizons during the pandemic. Findings suggest that playing the game helped satisfy various psychological needs—autonomy, relatedness, and competence—as described by Self-Determination Theory. Conversely, players stopped playing the game when they found that their psychological needs were thwarted or better met through other activities. Our findings offer support that video games can offer psychological relief in stressful contexts by providing opportunities for people to satisfy key psychological needs. Theoretical and practical implications are discussed.

The prevalence of gaming and gambling in a child and adolescent psychiatry unit

Background:

Gaming and gambling are frequently reported from child and adolescent psychiatry and school health care. Swedish epidemiological data show that 1.3% of the population meet the criteria for gambling disorder. Risk factors are male gender, young age, single status and being born outside Sweden. Both problem gaming and gambling are associated with compulsion, psychiatric and physical symptoms, impaired cognitive development and school performance. Based on the limited knowledge and the need for more research into these behaviours among young individuals, the present study aimed to look at the prevalence of gaming and gambling in patients at the child and adolescent psychiatry department (CAP) in Skåne, a region in the south of Sweden.

Design and methods:

The overall aim is to explore gaming and gambling in a child and youth population. Children aged 8–18 years ( N = 144) from CAP in Skåne were assessed with two self-screening instruments: GASA (Game Addiction Scale for Adolescents) and NODS-CLiP (NORC Diagnostic Screen for Gambling Problems). Information were collected regarding type of care, housing situation and diagnosis.

Results:

Thirty-three percent of the study participants showed problem/addictive gaming. Fifty-two percent of the males in the study showed problem/addictive gaming. Forty-four percent of the subjects with ADHD showed problem/addictive gaming. Eleven percent of the study participants showed problem gambling.

Conclusions:

The present study reports hitherto unreported figures of problem gaming and gambling. Our results show the importance of screening children and adolescents for these conditions when admitting subjects to CAP in/outpatient care.

The Adverse Effect of Gaming Disorder on the Family System in the Society

BACKGROUND: The Internet has been a part of life and the development of technology. Internet addiction is one of the problems among adolescents, especially in Indonesia. Family dysfunction is thought to be a factor causing Internet addiction in adolescents. Family cannot always supervise adolescents, and adolescents are required to have good self-control to avoid problematic gaming behavior and online game addiction. If not taken seriously, game addiction can interfere with the physical and mental health of adolescents. AIM: This study aimed to identify the relationship between family functioning and Internet gaming disorder among adolescents in Aceh. Currently, Aceh is the only province in Indonesia implementing sharia (the Islamic law). METHODS: This was a quantitative study with a descriptive correlational method. The samples of this study were 157 male senior high school students. This research was conducted from January to April 2021. Data were collected by a self-report questionnaire and analyzed using the logistic analysis to identify the correlation between family functioning and Internet gaming disorder. RESULTS: The results showed that family functions such as communication functions (p = 0.034), affective engagement (p = 0.006), and behavioral control (p = 0.000) were significantly related to Internet gaming disorders in adolescents. This assumption is evidenced by the results of statistical tests that show a value (<0.05). While the problem-solving function (p = 0.916) and the general function (p = 0.606) obtained a significant value (>0.05) so it can be concluded both of these family functions were not related to Internet gaming disorder. CONCLUSION: The family functions are significantly related to Internet gaming disorders in adolescents. Maximizing family functions is one solution to prevent Internet gaming disorders in adolescents.

Escapism-Based Motivation Affected the Psychological Performances of High-Risk Internet Gaming Disorder Individuals

Background

Escapism-based motivation (EBM) is considered as one of the diagnostic criteria for internet gaming disorder (IGD). However, how EBM affects the high risk of IGD (HIGD) population remains unclear.

Methods

An initial number of 789 college students participated in the general, internet gaming behavior, and motivation surveys. After multiple evaluations, 57 individuals were identified as HIGD (25 with EBM, H-EBM; 32 with non-EBM, H-nEBM). In addition, 51 no-gaming individuals were included as the control group (CONTR). The cohorts completed the psychological assessments and eye-tracking tests, and analyses of group differences, correlations, and influencing factors of the indicators were performed.

Results

The Barratt impulsiveness score of H-nEBM and H-EBM was significantly higher than that of CONTR (MD = 3.605, P = 0.017; MD = 3.744, P = 0.022). In addition, emotional intelligence self-emotion management ability was significantly lower in the H-EBM than in CONTR (MD = -2.038, P = 0.004). Correct rates and reaction times in the anti-saccade task differed significantly between the three groups (F = 3.525, P = 0.033; F = 4.459, P = 0.014). However, no differences were found in the comparison of the digital span test (DST), trail making test (TMT), animal verbal fluency test, Stroop test, and mental rotation test results. The anti-saccade test indicators were positively correlated with the DST results but negatively correlated with the Stroop test results (P < 0.05). Correct rates in the mental rotation test were negatively correlated with the TMT results but positively correlated with the DST results (P < 0.05). The participants with high Stroop test scores and no lover experience and who were raised by their grandparents were likely to develop EBM to engage in high risk of internet gaming disorder (P < 0.05).

Conclusion

EBM has a significantly negative effect on impulsivity, self-emotion management ability, and response inhibition in the HIGD participants.

Effects of Psychological Distress and Coping Resources on Internet Gaming Disorder: Comparison between Chinese and Japanese University Students

The high prevalence of Internet gaming disorder (IGD) among Asian youth indicates an urgent need to identify protective factors and examine their consistency across Asian cultures in order to facilitate cost-effective interventions. Based on the transactional theory of stress and coping, this study collected data of 1243 online gamers (45% males; 18-25 years) through an anonymous survey from universities in China and Japan and investigated whether three coping resources (i.e., mindfulness, coping flexibility, and social support) serve to protect Chinese and Japanese youth from the impact of psychological distress on IGD tendency. After adjusting for the measurement non-invariance across samples, we found that Japanese students reported higher levels of IGD tendency and psychological distress than Chinese students. The results of multiple-group SEM analyses showed that, after controlling for other predictors, mindfulness served as the strongest protective factor against IGD across samples. Moreover, the buffering effect of mindfulness on the association between psychological distress and IGD tendency of female (but not male) students was observed. Our findings highlighted the cross-cultural invariance of the impact of psychological distress and coping resources on IGD in Chinese and Japanese youth, which can be considered in future IGD prevention programs.

Problem Gaming and Suicidality: A Systematic Literature Review

•

This is the first review on the association between problem gaming and suicidality.

•

12 studies were identified, all of which found a positive association.

•

Future studies should investigate the causality and mechanisms in the relationship.

Background

No studies have so far synthesised the current evidence concerning a possible relationship between problem gaming and suicidality. We therefore conducted a systematic review of the literature. Our objective was to investigate the relationship between problem gaming and suicidality. The review was funded by the Norwegian Competence Center for Gambling and Gaming Research.

Methods

The review was pre-registered in PROSPERO International prospective register of systematic reviews (CRD42021279774). Searches were conducted in Web of Science, PsycINFO, EMBASE, PubMed and Google Scholar, September 2021. Studies that reported data on the relationship between problem gaming and suicidality, published between 2000 and 2021, and written in any European language were included. Studies investigating internet addiction/problematic internet use and not problem gaming, specifically, and studies investigating mental health in general or mental health outcomes other than suicidality, were excluded. Data from the included studies were extracted independently by two coders who also evaluated for risk of bias using the Newcastle-Ottawa Quality Assessment Scale. The results from each included study were presented in a table.

Results

A total of 12 cross-sectional studies, with in total 88,732 participants, were included in the review. In total 10 studies investigated the association between problem gaming and suicidal ideation. One of these also investigated the association between problem gaming and suicide attempts. Two studies combined suicidal ideation and suicide attempts into one variable and investigated the association between that variable and problem gaming. In total 11 of the 12 included studies found positive, crude associations between problem gaming and suicidal ideation/attempts. Five studies adjusted for possible confounding variables. Three of these still found significant associations between problem gaming and suicidal ideation, one found a positive but not statistically significant association, and the fifth found an inverse, non-significant association.

Discussion

The current findings indicate that there is an association between problem gaming and suicidal ideation, and likely between problem gaming and suicide attempts. The most important limitation of the included studies is the lack of longitudinal designs. Future studies should aim to investigate the causality and mechanisms in the relationships using more stringent designs.

Interaction Effects of DRD2 Genetic Polymorphism and Interpersonal Stress on Problematic Gaming in College Students

Problematic gaming has become a public concern, influenced both by genetic factors and stressful environments. Studies have reported the effects of dopamine-related genes and interpersonal stressors on problematic gaming, but gene and environment interaction (G × E) studies have not been conducted. In this study, we investigated the interaction effects of dopamine receptor D2 (DRD2) polymorphisms and interpersonal stress on problematic gaming and the mediating effect of avoidant coping to reveal the mechanism of the G × E process. We recruited 168 college students (mean age = 22; male 63.1%) and genotyped their DRD2 C957T (rs6277) and Taq1 (rs1800497) polymorphisms. The results of the mediated moderation analysis showed that, when experiencing interpersonal stressors, individuals with both the C957T T allele and the Taq1 A1 allele showed more elevated problematic gaming scores than non-carriers. Moreover, the interaction effect of the combined DRD2 polymorphisms and interpersonal stress was significantly mediated by avoidant coping. These findings suggest that the influence of interpersonal stress on problematic gaming can be changed as a function of DRD2 genotypes, which may be because of the avoidant coping styles of C957T T allele and Taq1 A1 allele carriers in response to stress.

Investigating the Role of Health Factors and Psychological Well-Being in Gaming Disorder

The recent recognition of Gaming Disorder (GD) as a mental health issue has provided a unique opportunity for researchers to advance our current understanding of the intricate relationships between GD and specific health-related factors and well-being. This study sought to investigate the role of key physical and psychological health and well-being factors in GD. To achieve this, three goals were explored. First, we tested whether GD can be predicted by health and well-being factors such as depression, anxiety, loneliness, attention problems, physical health problems (PHP), and psychological well-being (PWB). Second, we assessed the role of distress tolerance (DT) as a moderator in the relationship between PWB and GD. Third, we examined whether PWB would mediate the relationship between PHP and GD. A sample of 474 participants (Mean_age = 28.86 years; SD = 9.23; range: 18-66 years; 47 percent female) were recruited. The results of the multiple linear regression analysis indicated that age, attention problems, and PHP significantly predicted GD (R² = 0.15). In addition, the mediation findings uncovered an important direct association between PHP and GD despite the lack of mediation effects through PWB and the absence of moderating effects from DT. The present findings signify important health-related implications related to GD that are further discussed here in terms diagnosis, treatment, and prevention efforts.