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Xu X, Ma X, Ni H, Wang H, Wang T, Liu C, Song X, Dong GH. Mindfulness Meditation Training Reduces Gaming Cravings by Reshaping the Functional Connectivity Between the Default Mode Network and Executive Control-Related Brain Regions. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:827-836. [PMID: 38692393 DOI: 10.1016/j.bpsc.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Internet gaming disorder (IGD) can lead to psychological problems and cause behavioral problems in individuals. Traditional interventions have been ineffective in treating IGD. Meanwhile, mindfulness meditation (MM) is an emerging method that has proven to be effective for treating psychiatric disorders. In this study, MM was used to intervene in IGD and to explore its neural mechanism. METHODS Eighty participants were recruited through advertisements. Eventually, 61 completed the 1-month training (MM group, n = 31; progressive muscle relaxation [PMR] group, n = 30), including a pretest, 8 training sessions, and a posttest. Regional homogeneity and degree centrality were calculated, and the tests (pre- and post-) and group (MM and PMR) analysis of variance was performed. The overlapping results were obtained as region of interest for functional connectivity (FC) analyses. Behavioral data and neurotransmitter availability maps were correlated with FC. RESULTS Compared with PMR, MM decreased the severity of addiction and game craving in IGD. Brain imaging results showed that the FC between and within the executive control and default mode networks/reward-related regions were enhanced. Significant negative correlations were observed between FC and dopamine receptor D2, dopamine transporter, and vesicular acetylcholine transporter. Significant positive correlations were observed between FCs and serotonin and aminobutyric acid receptors. CONCLUSIONS This study confirmed the effectiveness of MM in treating IGD. MM altered the default mode and enhanced top-down control over game cravings. These findings were revealed by the correlations between brain regions and behavioral and biochemical effects. The results show the neural mechanism of MM in reducing IGD and lay the foundation for future research.
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Affiliation(s)
- Xuefeng Xu
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, China; Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Xuefeng Ma
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, China; Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Haosen Ni
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, China; Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Huabin Wang
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, China; Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Tongtong Wang
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, China; Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Chang Liu
- NuanCun Mindful-living Mindfulness Center, Hangzhou, Zhejiang Province, China
| | - Xiaolan Song
- Center of Mindfulness, School of Psychology, Zhejiang Normal University, Jinhua, Zhejiang Province, China
| | - Guang-Heng Dong
- Department of Psychology, Yunnan Normal University, Kunming, Yunnan Province, China.
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Simonelli V, Narzisi A, Sesso G, Salvati A, Milone A, Viglione V, Tolomei G, Masi G, Berloffa S. Internet Gaming Disorder in Children and Adolescents with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder. Brain Sci 2024; 14:154. [PMID: 38391728 PMCID: PMC10887068 DOI: 10.3390/brainsci14020154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have been related to an increased risk for behavioral addictions including online gaming. However, the relationship between these two conditions and Internet gaming disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ASD youth and ADHD youth, compared with a normal control group, and by assessing selected psychopathological and neuropsychological features in ASD and ADHD patients with and without IGD. This study included 77 ASD patients (67 males, mean age 13.58 ± 2.75 years), 94 ADHD patients (79 males, mean age 11.46 ± 2.47 years), and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) that received structured measures for IGD (IAT, IGDS9-SF, and UADI). In the ADHD group, 72.34% of the sample were above the IGD cut-off, compared with 45.45% in the ASD group and 9.5% in the NC group. ASD patients with IGD presented with greater severity and more severe attention problems, with no difference in the ASD core symptoms between patients with and without IGD. In the comparison between the ASD and ADHD groups according to the presence of IGD, ASD patients with IGD were the most severe group according to the CGI (Clinical Global Impression) scale. The follow-up, conducted on 45 patients affected by ASD, showed an improvement in CGI and CGAS (Children's Global Assessment Scale) scores, but not in the IGD symptoms. These findings could place the diagnosis of ASD as a negative prognostic factor in the follow-up of aspects of video game addiction compared with ADHD.
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Affiliation(s)
- Valerio Simonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56128 Pisa, Italy
| | - Antonio Narzisi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, 56025 Pisa, Italy
| | - Gianluca Sesso
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, 56025 Pisa, Italy
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, 55100 Lucca, Italy
| | - Andrea Salvati
- Child and Adolescent Psychiatry Unit, A. Meyer Children's Hospital, Viale Pieraccini 24, 50139 Florence, Italy
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, 56025 Pisa, Italy
| | - Valentina Viglione
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, 56025 Pisa, Italy
| | - Greta Tolomei
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, 56025 Pisa, Italy
| | - Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, 56025 Pisa, Italy
| | - Stefano Berloffa
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, 56025 Pisa, Italy
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Danielsen PA, Mentzoni RA, Låg T. Treatment effects of therapeutic interventions for gaming disorder: A systematic review and meta-analysis. Addict Behav 2024; 149:107887. [PMID: 37826910 DOI: 10.1016/j.addbeh.2023.107887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023]
Abstract
The prevalence of gaming disorder is assumed to be between 2%-5%. The treatment effect of different therapeutic interventions of gaming disorder has not been studied extensively. This systematic review and meta-analysis sought to identify all intervention studies on gaming disorder with a control group, determine the effect of the interventions, and examine moderators. Studies applying a therapeutic intervention and using an appropriate comparison group were identified by searching electronic databases, previous reviews, and reference lists. Data on type of treatment, name of outcome measurement, symptom level and other study characteristics were extracted and analyzed using meta-analysis and meta-regression. A total of 38 studies and 76 effect sizes, originating from 9524 participants were included. RoB2 and ROBINS-I risk of bias tools were used to assess within-study risk of bias. Correlational hierarchical models with robust variance estimation were fitted to effect size data and yielded a moderate summary estimate. Egger's sandwich test, funnel plot inspections, and other tests were conducted to assess risk of bias between studies. Results indicate that there may be an overall effect of therapeutic interventions for gaming disorder, but confidence in these findings is compromised by small-study effects, possible publication bias, a limited study pool, and a lack of standardization. The field needs more higher quality studies before the evidence-base can support reliable meta-analytic estimates.
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Affiliation(s)
- Paul A Danielsen
- Department of Psychology, UiT the Arctic University of Norway, Norway.
| | - Rune A Mentzoni
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
| | - Torstein Låg
- University Library, UiT the Arctic University of Norway, Norway
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Salvati A, Sesso G, Lenzi F, Masi G, Berloffa S. Efficacy of Methylphenidate for Internet Gaming Disorder and Internet Addiction in Patients with Attention-Deficit/Hyperactivity Disorder. Curr Pharm Des 2024; 30:477-483. [PMID: 38299404 DOI: 10.2174/0113816128281014240124074845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/22/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Internet Gaming Disorder (IGD) and Internet Addiction (IA) are related clinical conditions often comorbid with Attention-Deficit/Hyperactivity Disorder (ADHD). OBJECTIVE We evaluated the efficacy of MPH for IGD/IA symptoms in ADHD patients. METHODS We enrolled 38 drug-naive patients diagnosed with ADHD (Attention-Deficit/Hyperactivity Disorder) and IGD/IA. At baseline, all patients underwent a clinical assessment for IGD/IA symptoms and then received the most appropriate therapy according to their clinical profile. Twenty-one patients received MPH (methylphenidate) treatment, and 17 patients did not. Patients were re-evaluated after three months of treatment. RESULTS Findings revealed significant reductions in IGD/IA symptoms over time, while no significant effect of MPH on symptom reduction was found. Clinical predictors of symptom reduction were identified, including IQ (Intelligence Quotient) and comorbid anxiety. CONCLUSION This longitudinal prospective study contributes to the understanding of IGD/IA treatment in ADHD patients and highlights the importance of considering individual clinical characteristics when predicting treatment response. However, MPH may not directly impact IGD/IA symptom reduction.
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Affiliation(s)
- Andrea Salvati
- Child and Adolescent Psychiatry, Neuroscience Department, IRCCS Children's Hospital A. Meyer, University of Florence, Florence, Italy
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation Hospital, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, Pisa 56025, Italy
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Francesca Lenzi
- IRCCS Stella Maris Foundation Hospital, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, Pisa 56025, Italy
| | - Gabriele Masi
- IRCCS Stella Maris Foundation Hospital, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, Pisa 56025, Italy
| | - Stefano Berloffa
- IRCCS Stella Maris Foundation Hospital, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331A, Calambrone, Pisa 56025, Italy
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Mestre-Bach G, Potenza MN. Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:75-91. [PMID: 37594217 PMCID: PMC10444012 DOI: 10.1080/19585969.2023.2242359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.
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Affiliation(s)
- Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación (CITEI), Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
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6
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Hong JS, Bae S, Starcervic V, Han DH. Correlation Between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder. J Atten Disord 2023; 27:1252-1262. [PMID: 37254501 DOI: 10.1177/10870547231176861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Individuals with internet gaming disorder (IGD) or gaming disorder (GD) had a higher prevalence of ADHD than individuals without IGD or GD. The overpathologizing of excessive gaming behaviors may be associated with the functional impairment due to ADHD in individuals with GD. METHODS The present study was designed to compare the gaming patterns, accompanying psychopathology, and co-occurring psychiatric disorders, especially ADHD, between clinical and general gamer samples (17-29 years old). RESULTS Out of the nine IGD criteria, the item "functional impairment" had low diagnostic accuracy in participants with IGD or GD. The IGD (GD) group had a higher prevalence of ADHD compared to the general gamer group. Conversely, there was a higher prevalence of IGD (GD) in the ADHD group compared to the non-ADHD group. DISCUSSION The possibility of ADHD should be considered when IGD or GD is diagnosed in patients with problematic Internet gaming.
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Affiliation(s)
- Ji Sun Hong
- Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Sujin Bae
- Chung-Ang University, Seoul, Republic of Korea
| | | | - Doug Hyun Han
- Chung-Ang University Hospital, Seoul, Republic of Korea
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7
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de Sá RRC, Coelho S, Parmar PK, Johnstone S, Kim HS, Tavares H. A Systematic Review of Pharmacological Treatments for Internet Gaming Disorder. Psychiatry Investig 2023; 20:696-706. [PMID: 37559452 PMCID: PMC10460977 DOI: 10.30773/pi.2022.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Internet gaming disorder (IGD) is an increasingly common behavioral addiction, with an estimated global prevalence of 3%. A variety of pharmacological treatments have been used to treat IGD, yet no review to date has synthesized clinical trials evaluating their efficacy. This systematic review therefore synthesized the literature reporting on clinical trials of pharmacological treatments for IGD. METHODS We reviewed articles from MEDLINE, Embase, PubMed Central, CINAHL, and PsycINFO that were published as of March of 2022. A total of 828 articles were retrieved for review and 12 articles were included, reporting on a total of 724 participants. RESULTS Most participants were male (98.6%), and all were currently living in South Korea. The most common drugs used to treat IGD were bupropion, methylphenidate, and a range of selective serotonin reuptake inhibitors. The Young Internet Addiction Scale was the most frequently used to measure gaming-related outcomes. All studies reported reduced symptoms of IGD from pre- to post-treatment. Across all clinical trials, IGD symptom reductions following the administration of pharmacological treatments ranged from 15.4% to 51.4%. A risk of bias assessment indicated that only four studies had a low risk of bias. CONCLUSION Preliminary results suggest that a wide array of pharmacological interventions may be efficacious in the treatment of IGD. Future studies using double-blind randomized controlled trial designs, recruiting larger and more representative samples, and controlling for psychiatric comorbidities are needed to better inform understanding of pharmacological treatments for IGD.
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Affiliation(s)
| | - Sophie Coelho
- Department of Psychology, York University, Toronto, ON, Canada
| | - Puneet Kaur Parmar
- Department of Psychology, Toronto Metropolitan University Toronto, ON, Canada
| | - Samantha Johnstone
- Department of Psychology, Toronto Metropolitan University Toronto, ON, Canada
| | - Hyoun Soo Kim
- Department of Psychology, Toronto Metropolitan University Toronto, ON, Canada
| | - Hermano Tavares
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Ayub S, Jain L, Parnia S, Bachu A, Farhan R, Kumar H, Sullivan A, Ahmed S. Treatment Modalities for Internet Addiction in Children and Adolescents: A Systematic Review of Randomized Controlled Trials (RCTs). J Clin Med 2023; 12:jcm12093345. [PMID: 37176784 PMCID: PMC10179495 DOI: 10.3390/jcm12093345] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/06/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND In recent years, the use of the internet among children and adolescents has dramatically increased, leading to growing concerns regarding the potential risks of excessive internet use and addiction. Addressing these concerns, this systematic review aims to summarize current evidence on the effectiveness of treatment interventions for internet addiction among children and adolescents. METHOD We performed a systematic review using PubMed, Web of Science, PsycInfo, and Google Scholar with search terms including "internet addiction", "problematic internet use", "children" or "adolescents", "treatment" and "randomized controlled trial". We found 10 Randomized Controlled Trials (RCTs) meeting the criteria and included them in this systematic review. RESULTS This systematic review analyzed 10 randomized controlled trials focused on treatment interventions for internet addiction in adolescents and young adults. The interventions used were diverse, including cognitive-behavioral therapy (CBT), medication, electro-acupuncture (EA), and solution-focused approaches. The measures used to assess the effectiveness of the interventions also varied, but most studies reported moderate to large effect sizes for at least some outcomes. Overall, the studies suggest that interventions such as CBT and EA can be effective in reducing symptoms of internet addiction, internet gaming disorder, and unspecified internet use disorders. School-based programs and brief manualized CBT programs also show promise, though more research is needed to determine their long-term effectiveness. CONCLUSION Promising treatment approaches for internet addiction are emerging, but inconsistencies in conceptualization, language, and diagnostic criteria present some challenges. The growing recognition of problematic internet use, as shown by the DSM-5's recognition of Internet Gaming Disorder, highlights the need for a multidisciplinary approach and standardized criteria to facilitate accurate reporting across studies. Continued research is needed to identify effective treatments and diagnostic criteria for internet addiction, with the potential to offer practical insights into effective medications and therapies.
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Affiliation(s)
- Shahana Ayub
- Cornerstone Family Healthcare, Newburgh, NY 12550, USA
| | - Lakshit Jain
- Department of Psychiatry, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06032, USA
| | - Shanli Parnia
- CIMPAR, 101 Madison St. Suite 300, Oak Park, IL 60302, USA
| | - Anil Bachu
- Psychiatry Residency Program, Baptist Health UAMS Hospital, 3500 Springhill, Suite 100, North Little Rock, AR 72116, USA
- AHN Psychiatry and Behavioral Health Institute, 4 Allegheny Center, 8th Floor, Pittsburgh, PA 15212, USA
| | - Rabeea Farhan
- Rutgers School of Public Health, 683 Hoes Ln W, Piscataway, NJ 08854, USA
| | - Harendra Kumar
- Dow University of Health Sciences Karachi, Karachi City 74200, Pakistan
| | - Amanda Sullivan
- Quinnipiac University, 275 Mount Carmel Avenue, Hamden, CT 06518, USA
| | - Saeed Ahmed
- Rutland Regional Medical Center, 160 Allen Street, Rutland, VT 05701, USA
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Mestre-Bach G, Potenza MN. Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions. Nutrients 2023; 15:827. [PMID: 36839185 PMCID: PMC9962023 DOI: 10.3390/nu15040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023] Open
Abstract
The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.
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Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 Logroño, Spain
| | - Marc N. Potenza
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06510, USA
- Yale Child Study Center, School of Medicine, Yale University, New Haven, CT 06510, USA
- Department of Neuroscience, School of Medicine, Yale University, New Haven, CT 06510, USA
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10
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Chen Y, Lu J, Wang L, Gao X. Effective interventions for gaming disorder: A systematic review of randomized control trials. Front Psychiatry 2023; 14:1098922. [PMID: 36815197 PMCID: PMC9940764 DOI: 10.3389/fpsyt.2023.1098922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To identify effective intervention methods for gaming disorder (GD) through a rigorous assessment of existing literature. METHODS We conducted a search of six databases (PubMed, Embase, PsycINFO, CNKI, WanFang, and VIP) to identify randomized controlled trials (RCTs) that tested GD interventions, published from database inception to December 31, 2021. Standardized mean differences with 95% confidence intervals were calculated using a random effects model. Risk of bias was assessed with the Risk of Bias 2 (RoB 2) tool. RESULTS Seven studies met the inclusion criteria. Five interventions were tested in these studies: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). Four of the five interventions (the tDCS was excluded) were found to have a significant effect on GD. The results of the quality assessment showed that the included studies had a medium to high risk in the randomization process and a medium to high risk of overall bias. CONCLUSION Rigorous screening identified that four interventions are effective for GD: group counseling, CBI, ACRIP, and short-term CBT. Additionally, a comprehensive review of the literature revealed that improvements could be made in the conceptualization of GD, experimental design, sample representativeness, and reporting quality. It is recommended that future studies have more rigorous research designs and be based on established standards to provide more credible evidence to inform the development of GD interventions.
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Affiliation(s)
- Yuzhou Chen
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Jiangmiao Lu
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Ling Wang
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Xuemei Gao
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
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Hong YN, Hwang H, Starcevic V, Choi TY, Kim TH, Han DH. Which is more stable and specific: DSM-5 internet gaming disorder or ICD-11 gaming disorder? A longitudinal study. Psychiatry Clin Neurosci 2022; 77:213-222. [PMID: 36562926 DOI: 10.1111/pcn.13522] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/21/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
AIM The high comorbidity rates of internet gaming disorder (IGD) and gaming disorder (GD) with other psychiatric disorders are concerning. A follow-up study of gamers from clinical and nonclinical samples with and without diagnoses of IGD or GD was conducted to investigate the changes in diagnoses over a 1-year period, compare their diagnostic stability, and examine the patterns of co-occurrence between IGD and GD with other psychiatric disorders over the same period. METHODS Baseline and 1-year follow-up data of 279 participants, including 120 problematic gaming patients and 159 gamers from the general population, were analyzed. Information on demographics, gaming habits, and self-reported psychological status was collected. Additionally, a structured interview was conducted using the Gaming Diagnostic Interview and the Mini-International Neuropsychiatric Interview. RESULTS Although there was no significant difference between the changes in IGD/GD diagnosis during the 1-year period, 34.7% of the participants had a change in IGD diagnosis, while the number of GD cases increased to 60.4%. When evaluating the fixed effects of comorbidity on IGD and GD, attention-deficit/hyperactivity disorder had the highest odds ratio for both IGD (75.23; 95% confidence interval [CI], 10.67-530.61) and GD (117.02 × 106 ; 95% CI, 2.23 × 106 -6132.64 × 106 ). CONCLUSION These results reveal that a GD diagnosis might be more prone to change than an IGD diagnosis. GD was also found to be more affected by comorbid psychiatric disorders.
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Affiliation(s)
- Yu Na Hong
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Vladan Starcevic
- Sydney Medical School, Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Tae Young Choi
- Department of Psychiatry, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea
| | - Tae Ho Kim
- Department of Psychiatry, Konkuk University Chungju Hospital, Chunugju, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Fineberg NA, Menchón JM, Hall N, Dell'Osso B, Brand M, Potenza MN, Chamberlain SR, Cirnigliaro G, Lochner C, Billieux J, Demetrovics Z, Rumpf HJ, Müller A, Castro-Calvo J, Hollander E, Burkauskas J, Grünblatt E, Walitza S, Corazza O, King DL, Stein DJ, Grant JE, Pallanti S, Bowden-Jones H, Ameringen MV, Ioannidis K, Carmi L, Goudriaan AE, Martinotti G, Sales CMD, Jones J, Gjoneska B, Király O, Benatti B, Vismara M, Pellegrini L, Conti D, Cataldo I, Riva GM, Yücel M, Flayelle M, Hall T, Griffiths M, Zohar J. Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet. Compr Psychiatry 2022; 118:152346. [PMID: 36029549 DOI: 10.1016/j.comppsych.2022.152346] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/29/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023] Open
Abstract
Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.
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Affiliation(s)
- Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Natalie Hall
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche", University of Milan, Milan, Italy
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, and Wu Tsai Institute, Yale University, New Haven, USA, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, USA; Connecticut Mental Health Center, New Haven, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Giovanna Cirnigliaro
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Christine Lochner
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Hans Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, Research Group S:TEP (Substance use and related disorders: Treatment, Epidemiology and Prevention) University of Lübeck, Lübeck, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
| | - Eric Hollander
- Autism and Obsessive Compulsive Spectrum Program, Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, 00135 Palanga, Lithuania
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Ornella Corazza
- Department of Clinical Pharmacological and Biological Science, University of Hertfordshire
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Adelaide, Australia
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| | - Stefano Pallanti
- Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA; INS Istituto di Neuroscienze, Florence, Italy
| | | | - Michael Van Ameringen
- Deptartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Konstantinos Ioannidis
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Lior Carmi
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel; Reichman University, The Data Science Institution, Herzliya, Israel
| | - Anna E Goudriaan
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research & Arkin, the Netherlands
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Célia M D Sales
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal; Center for Psychology at University of Porto (CPUP), University of Porto, Porto, Portugal
| | - Julia Jones
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | | | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beatrice Benatti
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Matteo Vismara
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Luca Pellegrini
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Dario Conti
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Gianluigi M Riva
- School of Information and Communication Studies, University College Dublin
| | - Murat Yücel
- Brain Park, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | | | | - Joseph Zohar
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel
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Sherer J, Levounis P. Technological Addictions. Curr Psychiatry Rep 2022; 24:399-406. [PMID: 35792965 DOI: 10.1007/s11920-022-01351-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
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.
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Key Words
- Cybersex – online sexual activity, experienced alone or with others, that may involve technologies such as apps, webcams, or virtual reality that is not necessarily indicative of a disorder
- Internet addiction (IA) – an antiquated term which referred to addiction to the internet broadly speaking. It has largely been replaced with more specific terms
- Internet gaming disorder (IGD) – persistent overuse videogames leading to clinically significant impairment or distress played alone or with others online
- Online shopping addiction (OSA) – problematic shopping behavior via the internet that may be excessive, compulsive, and that causes economic, social, and emotional consequences
- Social media addiction (SMA) – preoccupation with social media, evidenced by irresistible urges to use and increasing time spent using online platforms, resulting in impairment or distress
- Technological addictions (TAs) – behavioral addictions that result from overutilization of modern technologies, many of which are necessary parts of everyday life today
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Affiliation(s)
- James Sherer
- New York University Grossman School of Medicine, 462 1st Ave, NB20N11, New York, NY, 10016, USA.
| | - Petros Levounis
- Rutgers New Jersey Medical School, 357 West 29th Street, 3A, New York, NY, 10001, USA
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Zheng Y, He J, Fan L, Qiu Y. Reduction of symptom after a combined behavioral intervention for reward sensitivity and rash impulsiveness in internet gaming disorder: A comparative study. J Psychiatr Res 2022; 153:159-166. [PMID: 35816975 DOI: 10.1016/j.jpsychires.2022.06.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/15/2022] [Accepted: 06/24/2022] [Indexed: 11/25/2022]
Abstract
Impulsivity is both a core symptom and a key psychological mechanism in Internet Gaming Disorder (IGD), and therefore interventions for impulsivity in IGD have both theoretical and practical value. However, previous related interventions only tended to focus on a single factor of impulsivity and achieved inconsistent results. In this study, based on the theory of two-factor model of impulsivity (reward sensitivity and rash impulsiveness), four groups of IGD subjects were recruited to investigate whether there were different effects of single rash impulsiveness or reward sensitivity intervention versus a combined intervention. By comparing the different factors of impulsivity of the four groups before and after a 15-day intervention, the results showed that: (1) compared with the control group, subjects in the Go/No-go training group only had a significantly lower level of rash impulsiveness, subjects in the Stimulus-Response Compatibility (SRC) training group only had a significantly lower level of reward sensitivity, and subjects in the combined training group had significantly lower levels of both impulsivity; (2) among the three intervention groups, only the subjects in the combined training group had significantly lower IGD scores in the follow-up measure. This study indicated that the behavioral training of Go/No-go and SRC were effective in improving rash impulsiveness and reward sensitivity in IGD, respectively, but the intervention effect of the combined training was better than that of the single training.
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Affiliation(s)
- Yang Zheng
- Key Laboratory of Adolescent Cyberpsychology and Behavior of Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
| | - Jinbo He
- Key Laboratory of Adolescent Cyberpsychology and Behavior of Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China.
| | - Liyan Fan
- Key Laboratory of Adolescent Cyberpsychology and Behavior of Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
| | - Yuting Qiu
- Key Laboratory of Adolescent Cyberpsychology and Behavior of Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China
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Abstract
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.
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Affiliation(s)
- James Sherer
- New York University Grossman School of Medicine, 462 1st Avenue, #NB20N11, New York, NY 10016, USA.
| | - Petros Levounis
- Rutgers New Jersey Medical School, 357 West 29th Street, #3A, New York, NY 10001, USA
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Current Status of Internet Gaming Disorder (IGD) in Japan: New Lifestyle-Related Disease in Children and Adolescents. J Clin Med 2022; 11:jcm11154566. [PMID: 35956181 PMCID: PMC9369635 DOI: 10.3390/jcm11154566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 02/01/2023] Open
Abstract
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.
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17
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Solly JE, Grant JE, Chamberlain SR. Pharmacological interventions for Problematic Usage of the Internet (PUI): A narrative review of current progress and future directions. Curr Opin Behav Sci 2022; 46:101158. [PMID: 35746944 PMCID: PMC7612886 DOI: 10.1016/j.cobeha.2022.101158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
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.
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Affiliation(s)
- Jeremy E Solly
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Department of Psychiatry, University of Cambridge, UK
| | - Jon E Grant
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
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Rojas-Jara C, Polanco-Carrasco R, Navarro-Castillo R, Faúndez-Castillo F, Chamorro-Gallardo M. “Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents. REVISTA COLOMBIANA DE PSICOLOGÍA 2022. [DOI: 10.15446/rcp.v31n2.90741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This study aims to characterize video game use disorder in adolescents, identifying the particularities of those who present it, its effects at the brain level, related factors, and existing measurement instruments. A systematic review of the scientific publications available in Scopus was carried out, between the period 2014-2018 on video game use disorder in adolescents. Adolescents with this disorder are characterized by being mostly men, spending more time daily and weekly playing than adolescents without this disorder, showing diverse symptoms in the behavioral, affective, and cognitive areas. At brain level, it is referred that in this disorder there is an increase and decrease in the activation of specific areas of the brain. Likewise, the presence of some psychological disorder and impulsivity are considered factors that increase the risk of suffering from it. However, there are protective factors as school commitment and parental supervision, among others.
How to cite: Rojas-Jara, C., Polanco-Carrasco, R., Navarro-Castillo, R., Faúndez-Castillo, F., & Chamorro-Gallardo, M. (2022). “Game (not) Over”: A Systematic Review of Video Game Disorder in Adolescents. Revista Colombiana de Psicología, 31(2), 45-64. https://doi.org/10.15446/rcp.v31n2.90741
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Exploring Internet gaming disorder: an updated perspective of empirical evidence (from 2016 to 2021). Compr Psychiatry 2022; 116:152319. [PMID: 35526417 DOI: 10.1016/j.comppsych.2022.152319] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/07/2022] [Accepted: 04/13/2022] [Indexed: 02/06/2023] Open
Abstract
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.
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Gorowska M, Tokarska K, Zhou X, Gola MK, Li Y. Novel approaches for treating Internet Gaming Disorder: A review of technology-based interventions. Compr Psychiatry 2022; 115:152312. [PMID: 35405548 DOI: 10.1016/j.comppsych.2022.152312] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/21/2022] [Accepted: 03/27/2022] [Indexed: 11/28/2022] Open
Abstract
Internet Gaming Disorder (IGD) has become a significant issue in mental healthcare over the past decades as the number of people engaging in excessive and unhealthy gaming increases with each year. Despite its inclusion in the 5th Edition of Diagnostic Statistical Manual and the development of a number of treatment methods that have been designed and tested for IGD, treatment remains a challenge. This review attempts to give an overview of the current state of IGD and its treatment with a specific focus on the potential of technology-based solutions, such as web-based programs, mobile applications, and virtual reality. The review also highlights the need for additional work in the area of treatment development for IGD and the preliminary evidence for the usefulness and importance of technology-based treatment methods which offer unique advantages, such as accessibility, scalability, and cost-effectiveness, over other existing treatment options.
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Affiliation(s)
- Monika Gorowska
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Klaudia Tokarska
- Aarhus University, Aarhus, Denmark; Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
| | - XinYu Zhou
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
| | - Mateusz Kazimierz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA; Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Yonghui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Internet Gaming Disorder in Children and Adolescents with Attention Deficit Hyperactivity Disorder. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030428. [PMID: 35327800 PMCID: PMC8947564 DOI: 10.3390/children9030428] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023]
Abstract
Although Attention Deficit Hyperactivity Disorder (ADHD) has been related to an increased risk for behavioral addictions, the relationship between ADHD and Internet Gaming Disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ADHD youth, compared to a normal control group, and by assessing selected psychopathological and cognitive features in ADHD patients with and without IGD. One hundred and eight patients with ADHD (mean age 11.7 ± 2.6 years, 96 males) and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) were included in the study and received structured measures for IGD. In the ADHD group, 44% of the sample were above the IGD cut-off, compared to 9.5% in the NC group. ADHD patients with IGD presented with greater severity and impairment, more severe ADHD symptomatology, more internalizing symptoms, particularly withdrawal/depression and socialization problems, and more prominence of addiction and evasion dimensions. A binary logistic regression showed that the degree of inattention presented a greater weight in determining IGD. These findings may be helpful for identifying, among ADHD patients, those at higher risk for developing a superimposed IGD.
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Chang CH, Chang YC, Yang L, Tzang RF. The Comparative Efficacy of Treatments for Children and Young Adults with Internet Addiction/Internet Gaming Disorder: An Updated Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052612. [PMID: 35270305 PMCID: PMC8909504 DOI: 10.3390/ijerph19052612] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
Internet gaming disorder (IGD) is a formal mental disorder leading to bad outcomes for children and adolescents. This study comprehensively compared the estimated effect of various pharmacotherapy and psychosocial interventions for IGD from randomized controlled trials (RCT) through updated meta-analysis, using meta-regression. A search of PubMed/MEDLINE, Cochrane Library, and Airiti Library between 2000 and 2017 was conducted for various IA/IGD intervention modalities. A total of 124 studies from 29 selected papers involving 5601 children and young adults with IA/IGD were found. Meta-analyzing the pooled standardized mean difference (SMD) revealed a preliminary random effect of 1.399 with a 95% confidence interval of 1.272–1.527, suggesting highly effective treatment of IA/IGD. After adjusting for the confounding risks of age, publication year, type of subjects, and type of study, this study revealed that combining pharmacotherapy with cognitive behavioral therapy (CBT) or multi-level counseling (MLC) was the most effective treatment option. Using a scale of time spent online or a severity of IA symptoms scale was a more effective measurement, with p-values = 0.006 and 0.002, respectively. IA/IGD patients with comorbid depression showed worse outcomes than youth with another comorbidity. The corresponding model goodness-of-fit indices were τ2 = 1.188; I2-Residual = 89.74%; and Adjusted-R2 = 16.10%. This systematic review indicates that pharmacotherapy combined with CBT or MLC might be an effective therapeutic strategy for youth with gaming disorder.
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Affiliation(s)
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei City 251301, Taiwan;
| | - Luke Yang
- Department of Social Welfare, Hsuan Chuang University, Hsinchu 30092, Taiwan;
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Department of Childhood Care and Education, Mackay Junior College of Medicine, Nursing, and Management, Taipei 25245, Taiwan
- Department of Audiology and Speech-Language Pathology, Mackay Medical College, New Taipei City 251301, Taiwan
- Correspondence: ; Tel.: +886-2-25433535
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Lampropoulou P, Siomos K, Floros G, Christodoulou N. Effectiveness of Available Treatments for Gaming Disorders in Children and Adolescents: A Systematic Review. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:5-13. [PMID: 34665018 DOI: 10.1089/cyber.2021.0067] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In 2020, the prevalence of gaming disorder (GD) was comparable with the prevalence of obsessive-compulsive disorder, thus demonstrating the necessity of addressing Internet gaming disorder (IGD) and GD in general. GD has been introduced as a psychiatric disorder by International Classification of Diseases and paving the way for treatment and prevention interventions. In this review, we researched available treatment interventions in children and adolescents. Τhe initial search resulted in 972 studies and we ended up with 16 by excluding inappropriate studies according to six inclusion criteria. The studies confirmed that cognitive-behavioral therapy (CBT) or CBT-based interventions are the most used, and in cases of comorbidity, such as depression or attention-deficit/hyperactivity disorder, the appropriate pharmaceutical intervention also was an effective option. Other interventions combined CBT with family therapy or CBT-based therapies that took place in specialized camps. Family as a supportive expedient or even treatment expedient seemed to play a major role. It is remarkable that only little knowledge exists regarding treatment interventions for children aged 8-12 years old. Therefore, more studies need to be carried out for this age range especially, with comparable efficacy to this of other interventions.
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Affiliation(s)
| | | | - Georgios Floros
- 2nd Department of Psychiatry, Aristotle University Medical School, Thessaloniki, Greece
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Seo EH, Yang HJ, Kim SG, Park SC, Lee SK, Yoon HJ. A Literature Review on the Efficacy and Related Neural Effects of Pharmacological and Psychosocial Treatments in Individuals With Internet Gaming Disorder. Psychiatry Investig 2021; 18:1149-1163. [PMID: 34872237 PMCID: PMC8721297 DOI: 10.30773/pi.2021.0207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/27/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Internet gaming disorder (IGD) has attracted considerable attention as a serious mental and public health issue worldwide. Currently, there are no established treatment guidelines for IGD. Herein, we review the latest findings on the efficacy and related neural effects of pharmacological and psychosocial treatments for individuals with IGD. METHODS A database search of relevant studies published between 2007 and 2020 was conducted using PubMed and Google Scholar. Twenty-seven studies were reviewed for current evidence related to the efficacy and neural effects of pharmacological and psychosocial IGD treatments. RESULTS Pharmacological studies suggest that bupropion may play a significant role in IGD. Additionally, nuclear imaging studies on IGD have demonstrated functional impairment of the dopamine system, providing a neurobiological basis for the efficacy of dopamineenhancing drugs. Among the various psychosocial interventions, current evidence suggests that cognitive behavioral therapy may be an effective intervention for IGD. Cognitive behavioral therapy and bupropion were found to influence resting-state functional connectivity within the cortico-subcortical circuit and default mode network, suggesting a possible neural mechanism. Innovative approaches, including virtual reality treatment, residential camps, voluntary abstinence, and transcranial direct current stimulation, have shown promising results. However, methodological limitations, such as the absence of proper controls, small sample sizes, short duration, inconsistency of inclusion criteria across studies, and self-report measures of outcome, hamper conclusions regarding the efficacy of treatments. CONCLUSION Ongoing basic research and clinical trials overcoming these limitations could add to the existing knowledge on IGD and contribute to the development of evidence-based treatments.
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Affiliation(s)
- Eun Hyun Seo
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Hae-Jung Yang
- Department of Psychiatry, Chosun University Hospital, Gwangju, Republic of Korea
| | - Seung-Gon Kim
- Department of Psychiatry, Chosun University Hospital, Gwangju, Republic of Korea.,Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seon-Cheol Park
- Department of Psychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Sang-Kyu Lee
- Department of Psychiatry, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Hyung-Jun Yoon
- Department of Psychiatry, Chosun University Hospital, Gwangju, Republic of Korea.,Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Muzwagi AB, Motiwala FB, Manikkara G, Rizvi A, Varela MA, Rush AJ, Zafar MK, Jain SB. How Are Attention-deficit Hyperactivity and Internet Gaming Disorders Related in Children and Youth? J Psychiatr Pract 2021; 27:439-447. [PMID: 34768266 DOI: 10.1097/pra.0000000000000582] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This review addresses important practical questions facing clinicians regarding internet gaming disorder (IGD) and attention-deficit/hyperactivity disorder (ADHD) in children and youth (C-Y). The authors investigated data concerning the risk that C-Y who have ADHD will develop IGD, whether effective treatment of ADHD positively influences the course of IGD in C-Y who have both, and other findings that might be of benefit to clinicians who treat C-Y with these conditions. METHODS We conducted a literature review using 4 databases: PubMed, Scopus, PsychInfo, and Embase. RESULTS C-Y with ADHD are at greater risk for developing IGD than those without ADHD. A close association exists between the severity of ADHD symptoms and the severity of IGD. It is unknown what proportion of C-Y with ADHD will develop IGD during their developmental trajectory; however, C-Y with IGD are at risk for developing ADHD, and ADHD can also increase the vulnerability of C-Y to IGD. Adolescents with ADHD and IGD have greater deficits in social skills than those with ADHD but no IGD. Lower parental occupational and socioeconomic status and poor family relationships are associated with more severe IGD symptoms. Atomoxetine and methylphenidate are equally effective in alleviating IGD symptoms comorbid with ADHD. CONCLUSIONS C-Y with ADHD are at increased risk for developing IGD compared with C-Y without ADHD, but it has not been determined at what developmental stage IGD is likely to emerge. Since IGD and ADHD are strongly associated, it is imperative to consider ADHD as a significant risk factor for IGD and vice versa, which can help psychiatrists be alert for early signs of IGD and manage them accordingly.
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Affiliation(s)
- Ashraf B Muzwagi
- MUZWAGI, MOTIWALA, MANIKKARA, RIZVI, VARELA, RUSH, ZAFAR, and JAIN: The Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX
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Lee J, Bae S, Kim BN, Han DH. Impact of attention-deficit/hyperactivity disorder comorbidity on longitudinal course in Internet gaming disorder: a 3-year clinical cohort study. J Child Psychol Psychiatry 2021; 62:1110-1119. [PMID: 33751554 DOI: 10.1111/jcpp.13380] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although attention-deficit/hyperactivity disorder (ADHD) symptoms were identified as a key risk factor for Internet gaming disorder (IGD), the effect of ADHD comorbidity on longitudinal course of IGD in the clinical population remains to be further examined. This study aimed to investigate whether ADHD comorbidity in IGD patients affects the recovery, recurrence rates, and trajectories of IGD symptoms, and examine the relationship between the changes in IGD and ADHD symptoms. METHODS The study included 128 IGD patients without any psychiatric comorbidities (pure-IGD group) and 127 IGD patients with comorbid ADHD (ADHD-IGD group) aged 11 to 42 years. IGD and ADHD were diagnosed according to DSM-5 criteria at enrollment. Participants were offered 8-week treatment with additional care provided as needed and followed up over a 3-year period. IGD diagnosis was reassessed annually and used as a dichotomous outcome. The severity of IGD and ADHD symptoms was measured using the Young Internet Addiction Scale and the Korean ADHD rating scale, respectively, at baseline and each annual follow-up. RESULTS The recovery rates of IGD by Year 3 were 60% and 93% in ADHD-IGD and in pure-IGD groups, respectively. The ADHD-IGD group showed lower rates of recovery, higher odds of recurrence within 1 year, and higher severity of IGD symptoms over time than the pure-IGD group. Family environment was also associated with the trajectories of IGD symptoms. The changes in ADHD symptoms were significantly associated with the changes in IGD symptoms. CONCLUSIONS This study found that ADHD comorbidity in IGD patients was associated with poor clinical course of IGD and that the changes in ADHD symptoms were associated with the changes in IGD symptoms over time. Our findings suggest that evaluation and treatment of ADHD symptoms and family environment in IGD patients may be important in improving the prognosis of IGD.
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Affiliation(s)
- Jung Lee
- Integrative Care Hub, Children's Hospital, Seoul National University Hospital, Seoul, Korea
| | - Sujin Bae
- Department of Psychiatry, Chung Ang University Hospital, Seoul, Korea
| | - Bung Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University Hospital, Seoul, Korea
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Randall J, York JA. Lessons Learned from the Impact of Adolescents’ Internet Use Disorders on Adolescents’ Substance Use Disorders. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2021. [DOI: 10.1080/1067828x.2021.1967247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jeff Randall
- Medical University of South Carolina, Charleston, SC, USA
| | - Janet A. York
- Medical University of South Carolina, College of Nursing, Charleston, SC, USA
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Dell’Osso B, Di Bernardo I, Vismara M, Piccoli E, Giorgetti F, Molteni L, Fineberg NA, Virzì C, Bowden-Jones H, Truzoli R, Viganò C. Managing Problematic Usage of the Internet and Related Disorders in an Era of Diagnostic Transition: An Updated Review. Clin Pract Epidemiol Ment Health 2021; 17:61-74. [PMID: 34497661 PMCID: PMC8386084 DOI: 10.2174/1745017902117010061] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Problematic Usage of the Internet (PUI) refers to a broad and likely heterogeneous group of Internet-related conditions associated with behavioural disturbances and functional impairment. METHODS Within PUI several conditions have been reported, including Gaming Disorder, Shopping Addiction, Cyberchondria, Gambling Disorder, Cyberpornography Addiction and Cyberbullying. While increasing reports in the field try to define the epidemiologic and clinical boundaries of these conditions, the rapid and continuous evolution of Internet related behaviours as well as their problematic/pathological expressions are often difficult to diagnose, assess, approach with treatment interventions and follow-up. RESULTS In addition, some of the PUI-related conditions show characteristics of addiction to the Internet as a preferential tool to engage in specific behaviours, while some others exclusively manifest on the Internet, making it necessary to find distinct assessment and treatment pathways. CONCLUSION The inclusion of Internet Gaming Disorder in Section III by the DSM-5 and the recognition of Gaming Disorder by the ICD-11 opened the way for a systematic clinical investigation of this and other PUI-related conditions, particularly in terms of preventive and therapeutic strategies. The present article is aimed at offering an updated clinical overview on the main expressions of PUI, focussing on the latest acquisitions in this evolving field.
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Affiliation(s)
- Bernardo Dell’Osso
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Psychiatry, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, Stanford, CA, USA
- Aldo Ravelli” Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy
| | - Ilaria Di Bernardo
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Matteo Vismara
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Eleonora Piccoli
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Federica Giorgetti
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Laura Molteni
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Naomi A. Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL8 6HG, UK
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Calogero Virzì
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Henrietta Bowden-Jones
- Central North West London NHS Trust, Division of Brain Science, Imperial College London, London, UK
| | - Roberto Truzoli
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Caterina Viganò
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
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Han DH, Bae S, Hong J, Kim SM, Son YD, Renshaw P. Resting-State fMRI Study of ADHD and Internet Gaming Disorder. J Atten Disord 2021; 25:1080-1095. [PMID: 31640464 DOI: 10.1177/1087054719883022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective: We aimed to understand whether Attention Deficit Hyperactivity Disorder (ADHD) and Internet gaming disorder (IGD) share similar brain functional connectivity (FC) between the frontal and subcortices. Method: We compared changes in clinical symptoms and brain activity using functional magnetic resonance imaging (fMRI) in 26 patients with ADHD but without IGD, 29 patients with ADHD and IGD, and 20 patients with IGD but without ADHD. Results: The functional connectivity (FC) from the cortex to subcortex in both groups was decreased relative to that in age-matched healthy participants. One-year treatment for ADHD and IGD symptoms increased the FC between the cortex and subcortex in all ADHD participants and all IGD participants with good prognoses compared with those in all ADHD participants and all IGD participants with poor prognoses. Conclusion: Patients with ADHD and IGD shared similar brain FC at baseline and FC changes in response to treatment.
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Affiliation(s)
| | - Sujin Bae
- Chung-Ang University, Seoul, South Korea
| | - Jisun Hong
- Chung-Ang University, Seoul, South Korea
| | - Sun Mi Kim
- Chung-Ang University Hospital, Seoul, South Korea
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Problematic internet use: The effect of comorbid psychopathology on treatment outcomes. Psychiatry Res 2021; 298:113789. [PMID: 33639406 DOI: 10.1016/j.psychres.2021.113789] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/03/2021] [Indexed: 12/26/2022]
Abstract
Problematic Internet use (PIU) behaviours involve one's maladaptive Internet use and have been often described as secondary manifestations of pre-existing psychopathology. Furthermore, different profiles of PIU sufferers have been proposed. However, little is known of the impact these may be having on treatment responses. Thus, this study aims to investigate the psychopathological profiles of those who seek treatment for PIU within a specialised public outpatient unit and whether these influence treatment outcomes. This research utilised 203 treatment seekers of the Specialized Department of Problematic Internet Use (SD-PIU) of the Psychiatric Hospital of Attica, in Greece (mean age = 26.02; SD = 7.9). To assess psychopathology, the Symptom Checklist-90 Revised (SCL-90-R) was used. Treatment responses were reported either as completed, continued, or drop out. A Latent Class/Profiling-Analysis (LCA) was performed, guided by variations across the SCL-90-R psychopathologies. It indicated two naturally occurring profiles of comorbid psychological symptoms; 66% were classified as the "High Comorbidity" (HC) and 34% as the "Low Comorbidity" (LC) profile. Regarding treatment outcomes, LC patients presented with significantly lower dropout rates and higher levels of completion. The present study poses imperative clinical implications regarding the necessity of specialized treatment planning based on the different PIU treatment seekers psychopathological comorbidities.
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Symptoms of Internet Gaming Disorder, Inattention, and Impulsivity: a Cross-Sectional Study Conducted in the United Arab Emirates. Psychiatr Q 2021; 92:301-310. [PMID: 32642820 DOI: 10.1007/s11126-020-09799-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The addictive use of internet video games is now recognized as a valid diagnostic construct by both the World Health Organization and the American Psychiatric Association. A burgeoning body of preliminary evidence points to a relationship between attention deficit and hyperactivity disorder (ADHD) symptoms as being a risk factor for behaviors indicative of internet gaming disorder (IGD), however, studies have rarely examined ADHD's two diagnostic constructs, inattention and impulsivity, separately. Moreover, IGD research is non-existent in Middle Eastern contexts. Therefore, this study examined, separately, the association of IGD with inattention and impulsivity in a sample of gamers from the United Arab Emirates. A cross-sectional survey was completed by 214 participants aged 18-33 years (mage = 20.64, SD = 4.34) who completed measures of IGD and ADHD, and self-reported daily duration of gameplay as well as a number of demographic characteristics. The pair of hierarchical linear regressions indicated that both the examined constructs, increased symptoms of inattention and impulsivity, were separately associated with elevated risk for engagement in IGD behaviors. However, these associations were not moderated by gender. These results confirm that symptoms of ADHD are indeed associated with IGD and is the first to confirm the presence of this relationship in a Middle Eastern sample.
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Abstract
PURPOSE OF REVIEW This review describes recent research findings and contemporary viewpoints regarding internet addiction in adolescents including its nomenclature, prevalence, potential determinants, comorbid disorders, and treatment. RECENT FINDINGS Prevalence studies show findings that are disparate by location and vary widely by definitions being used. Impulsivity, aggression, and neuroticism potentially predispose youth to internet addiction. Cognitive behavioral therapy and medications that treat commonly co-occurring mental health problems including depression and ADHD hold considerable clinical promise for internet addiction. SUMMARY The inclusion of internet gaming disorder in the DSM-5 and the ICD-11 has prompted considerable work demonstrating the validity of these diagnostic approaches. However, there is also a movement for a conceptualization of the disorder that captures a broader range of media-use behaviors beyond only gaming. Efforts to resolve these approaches are necessary in order to standardize definitions and clinical approaches. Future work should focus on clinical investigations of treatments, especially in the USA, and longitudinal studies of the disorder's etiology.
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Dullur P, Krishnan V, Diaz AM. A systematic review on the intersection of attention-deficit hyperactivity disorder and gaming disorder. J Psychiatr Res 2021; 133:212-222. [PMID: 33360866 DOI: 10.1016/j.jpsychires.2020.12.026] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 11/09/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Studies of Gaming Disorder (GD) consistently identify co-morbidity with various psychiatric disorders including major depression, obsessive compulsive disorder and anxiety disorders. One of the strongest associations has been with Attention Deficit Hyperactivity Disorder (ADHD). We present a systematic review of this association by pooling and integrating available evidence. METHODS PubMed, EMBASE, PsychInfo and CINHAHL were searched for articles that reported a quantitative association between GD and ADHD and its dimensions, using equivalent search terms. Quality appraisal was done using criteria adapted from the Critical Appraisal Skills Package (CASP) checklists. RESULTS 1028 articles were identified, of which 29 studies were included for systematic review (n = 56650 participants). Most of these studies were observational in nature, and were of moderate quality, with deficits particularly in the domains of generalisability and confounding. Community surveys (n = 18) of purposive samples constituted the majority, with fewer clinic-based samples (n = 11). While ADHD symptoms were consistently associated with GD, More frequent associations were displayed with inattention associations with GD than other ADHD subscales. There were no conclusive findings regarding the type of game on severity of either condition, or on completion of treatment. CONCLUSIONS The findings suggest an association between ADHD and GD, although the direction of the relationship is unclear. This has implications for clinical practice, policy and research. We recommend that ADHD is screened for when evaluating IGD as part of routine practice."
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Affiliation(s)
- Pravin Dullur
- Rupertswood Building, Mount Druitt Hospital, Consultant Child Psychiatrist, Blacktown Early Access Team (BEAT), Mount Druitt, Western Sydney Local Health District, Western Sydney University, 75, Railway Street, Mount Druitt, NSW, 2770, Australia.
| | - Vijay Krishnan
- All India Institute of Medical Sciences, Rishikesh, India
| | - Antonio Mendoza Diaz
- University of New South Wales, Faculty of Medicine, School of Psychiatry, 1 Campbell Street, Liverpool, NSW, 2170, Australia
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Kircaburun K, Pontes HM, Stavropoulos V, Griffiths MD. A brief psychological overview of disordered gaming. Curr Opin Psychol 2020; 36:38-43. [DOI: 10.1016/j.copsyc.2020.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/20/2022]
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Abstract
Playing video games (online or offline) is not a recent phenomenon and for most people it is a leisure activity with no adverse consequences whatsoever. However, for a small minority, gaming has the potential (akin to substance use) to lead on to problematic gaming and gaming disorder. Gaming disorder is a new entry in both the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases. Given gaming's ever-growing popularity, GPs, psychiatrists and other doctors will be increasingly likely to come across individuals who present with gaming-related problems. Consequently, this article gives doctors a basic understanding of what gaming disorder is, its presentations in practice and diagnosis, and its treatment.
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Affiliation(s)
- Sanju George
- Rajagiri School of Behavioural Sciences and Research, Rajagiri College of Social Sciences (Autonomous), Kochi, India
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Paschke K, Holtmann M, Melchers P, Klein M, Schimansky G, Krömer T, Reis O, Wartberg L, Thomasius R. [Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 48:303-317. [PMID: 32614281 DOI: 10.1024/1422-4917/a000735] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy Abstract. Media-associated disorders (MAD) describe the problematic use of the internet, certain electronic devices in general as well as digital applications. During childhood and adolescence, digital games and social media are the most commonly used applications. In May 2019, as first MAD "gaming disorder" was included as a clinical diagnosis in the ICD-11. The prevalence of MAD in German children and adolescents is estimated to lie between 3 % and 5 %. In most cases, MAD are accompanied by psychiatric comorbidities. MAD ensue because of dysfunctional learning processes in combination with general and specific risk factors. They are associated with neural changes like those of substance-associated addictions. Diagnostics can be based on validated questionnaires and clinical exploration, though a standardized diagnostic path is not yet common. Treatment depends on the level of severity and generally comprises outpatient, day-clinic, and inpatient therapy approaches with elements from cognitive-behavioral therapy and under parental involvement. Suitable treatments are not yet available in all German regions and have also not been sufficiently evaluated. Moreover, only a few studies exist on the efficacy of prevention measures addressing MAD in children and adolescents. Thus, further research is strongly required.
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Affiliation(s)
- Kerstin Paschke
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Martin Holtmann
- vLWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Hamm
| | - Peter Melchers
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Klinikum Oberberg, Kreiskrankenhaus Gummersbach und Klinik Marienheide, Gummersbach
| | | | | | - Thomas Krömer
- Gemeinschaftspraxis für Kinder- und Jugendpsychiatrie, Psychotherapie & Psychosomatik, Hamburg
| | - Olaf Reis
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universität Rostock, Rostock
| | - Lutz Wartberg
- Fakultät für Humanwissenschaften, MSH Medical School Hamburg, Hamburg
| | - Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
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Goslar M, Leibetseder M, Muench HM, Hofmann SG, Laireiter AR. Treatments for internet addiction, sex addiction and compulsive buying: A meta-analysis. J Behav Addict 2020; 9:14-43. [PMID: 32359229 PMCID: PMC8935188 DOI: 10.1556/2006.2020.00005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS Internet addiction, sex addiction and compulsive buying are common behavioral problems, which share similarities with gambling disorder and substance use disorders. However, little is known about the efficacy of their treatments. The objective of this meta-analysis was to examine the efficacy of the treatments of such problem behaviors, and to draw parallels to gambling disorder and substance use disorders in terms of treatment response. METHODS Literature search yielded 91 studies totaling 3,531 participants to provide a comprehensive evaluation of the short-term and long-term efficacy of psychological, pharmacological and combined treatments for internet addiction, sex addiction, and compulsive buying. RESULTS Psychological, pharmacological, and combined treatments were associated with robust pre-post improvements in the global severity of internet addiction (Hedges's g: 1.51, 1.13, and 2.51, respectively) and sex addiction (Hedges's g: 1.09, 1.21, and 1.91, respectively). For compulsive buying, psychological and pharmacological treatments were also associated with a large-sized pre-post reduction in global severity (Hedges's g: 1.00 and 1.52, respectively). The controlled pre-post and within-group pre-follow-up effect sizes were in the similar range, with few exceptions. Moderator analyses suggest that psychological interventions are effective for reducing compulsive behaviors, especially when delivered face-to-face and conducted over extended periods of time. Combinations of cognitive-behavioral approaches with medications showed an advantage over monotherapies. DISCUSSION AND CONCLUSIONS The results suggest that treatments for common behavioral addictions are effective in the short term, similar to those implemented for gambling disorder and substance use disorders, but more rigorous clinical trials are needed.
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Affiliation(s)
- Martina Goslar
- Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria,Corresponding author. Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria. Fax: +43/(0)662/8044 5126. E-mail:
| | - Max Leibetseder
- Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria
| | - Hannah M. Muench
- Psychosomatisches Zentrum Waldviertel (PSZW), Universitätsklinik für Psychosomatische Medizin der Karl Landsteiner Privat-Universität, Grafenbergerstraße 2, 3730, Eggenburg, Austria
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, 2nd Fl., Boston, MA, 02215, USA
| | - Anton-Rupert Laireiter
- Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria,Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Wien, Austria
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Chang CH, Chang YC, Cheng H, Tzang RF. Treatment Efficacy of Internet Gaming Disorder With Attention Deficit Hyperactivity Disorder and Emotional Dysregulaton. Int J Neuropsychopharmacol 2020; 23:349-355. [PMID: 32047929 PMCID: PMC7311645 DOI: 10.1093/ijnp/pyaa010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/16/2020] [Accepted: 02/10/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Recent youth with Attention Deficit Hyperactivity Disorder (ADHD) noticed emotional dysregulation if they had Internet Gaming Disorder (IGD). This study aims to understand the treatment efficacy of IGD with ADHD and emotional dysregulaton. METHOD A total of 101 ADHD youths were recruited. We used the Chen Internet Addiction Scale and IGD criteria of the diagnotsic statistical manual (DSM)-5 to confirm IGD. The Swanson, Nolan, and Pelham questionnaire Version IV was used for symptoms of ADHD and oppositional defiant disorder. Disruptive mood dysregulation disorder was assessed by psychiatrist. RESULTS There is a new phenomenon that emotional dysregulation has been frequently noticed in severely gaming-addicted ADHD youth. Treatment efficacy of IGD is good when the underlying symptom of ADHD is controlled. Symptom scores of disruptive mood dysregulation (DMDD) were significantly reduced by 71.9%, 74.8%, and 84.4% at week 2, 3, and 4, respectively (P ≤ .001) after adjusting baseline symptom severity. CONCLUSION IGD may strongly arouse emotional dysregulation. Future DSM criteria could consider these gaming-addicted youth as a specific subclass of ADHD.
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Affiliation(s)
- Chuan-Hsin Chang
- Agricultural Biotechnology Research Center, Academia Sinica, Taipei, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Helen Cheng
- Department of Psychiatry, Christian Hospital, Changhua, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan,Mackay Medical Colleges, New Taipei City, Taiwan,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan,Correspondence: Ruu-Fen Tzang, MD, Department of Psychiatry, Mackay Memorial Hospital, Number 92, Sec. 2, Zhong Shan N Road, Taipei 104, Taiwan ()
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Egorov AY, Grechanyi SV. [Current approaches to the treatment and correction of Internet addiction]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:152-159. [PMID: 31407696 DOI: 10.17116/jnevro2019119061152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
According to WHO consensus decision, gambling disorder, including the form of Internet addiction (IA), should be included in the section 'Impulsive disorders and behavioral addictions' of ICD-11. Population studies in the USA and Europe show the prevalence of IA from 1.5 to 8.2%, and in the countries of Southeast Asia it reaches 20-30% among young people. All this raises questions about the development of standardized approaches to the treatment and correction of this disorder. The review covers pharmacological and non-pharmacological approaches. Several studies and clinical observations have been devoted to pharmacological methods for treating IA, including the successful use of antidepressants such as escitalopram, clomipramine, and bupropion. There are data on the effectiveness of quetiapine, clonazepam, naltrexone and methylphenidate. In general, research was limited to methodological deficiencies, including small sample sizes, lack of control groups etc. Of non-pharmacological and psychotherapeutic approaches, in particular, cognitive-behavioral therapy (CBT) is the most studied. Special programs CBT are developed focused on children and teenagers. In addition to CBT, other psychotherapeutic approaches were used for the correction of IA: reality therapy, Internet interventions, acceptance and responsibility therapy, family therapy, complex methods. In many countries educational medical camps have been established (for example, sports or other outdoor activities) for adolescents with IA. Further studies in the field are needed to develop treatment approaches and diagnostic classification of IA.
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Affiliation(s)
- A Yu Egorov
- Sechenov Institute of Evolutionary Physiology and Biochemistry the Russian Academy of Sciences, St.-Petersburg, Russia; St.-Petersburg State University, St.-Petersburg, Russia; Mechnikov North-West State Medical University, St.-Petersburg, Russia
| | - S V Grechanyi
- St.-Petersburg State Pediatric Medical University, St.-Petersburg, Russia
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Zajac K, Ginley MK, Chang R. Treatments of internet gaming disorder: a systematic review of the evidence. Expert Rev Neurother 2019; 20:85-93. [PMID: 31544539 DOI: 10.1080/14737175.2020.1671824] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Introduction: The American Psychiatric Association included Internet gaming disorder (IGD) in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders, and the World Health Organization included gaming disorder in the 11th revision of the International Classification of Diseases. These recent updates suggest significant concern related to the harms of excessive gaming.Areas covered: This systematic review provides an updated summary of the scientific literature on treatments for IGD. Inclusion criteria were that studies: 1) evaluate the effectiveness of an intervention for IGD or excessive gaming; 2) use an experimental design (i.e. multi-armed [randomized or nonrandomized] or pretest-posttest); 3) include at least 10 participants per group; and 4) include an outcome measure of IGD symptoms or gaming duration. The review identified 22 studies evaluating treatments for IGD: 8 evaluating medication, 7 evaluating cognitive behavioral psychotherapy, and 7 evaluating other interventions and psychosocial treatments.Expert opinion: Even with the recent uptick in publication of such clinical trials, methodological flaws prevent strong conclusions about the efficacy of any treatment for IGD. Additional well-designed clinical trials using common metrics for assessing IGD symptoms are needed to advance the field.
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Affiliation(s)
- Kristyn Zajac
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Meredith K Ginley
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
| | - Rocio Chang
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
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Abstract
Gaming disorder is set to be included in the International Statistical Classification of Diseases and Related Health Problems alongside other behavioural addictions (gambling disorder) and substance-related addictions. Given the popularity of online gaming, this is set to become an increasingly common presentation to general mental health professionals, addiction specialists, and general practitioners. This article briefly examines online gaming and describes the characteristics of gaming disorder. Some features of online gaming that have addictive potential and similarities to other addictive behaviours such as gambling disorder are discussed. Finally, the article examines treatment options available for gaming disorder and treatment going forward from an Irish perspective.
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Abstract
PURPOSE OF REVIEW To review the literature and provide a guide to assessing patients with problematic interactive media use (PIMU). RECENT FINDINGS 0.3-1.0% of the world population meets criteria for internet gaming disorder (IGD). 26.8-83.3% of adolescents meeting criteria for internet addiction have comorbid attention-deficit/hyperactivity disorder. IGD is associated with increased anxiety and social anxiety/phobias. Group counseling, cognitive behavioral therapy, and sports intervention are associated with significant reductions in internet addiction. SUMMARY With the Diagnostic and Statistical Manual of Mental Disorders-5 inclusion of IGD under 'Conditions for Further Study' and the addition of gaming disorder to International Classification of Diseases (ICD)-11, the idea that PIMU is a mental health disorder gained traction. Although certain populations may be at increased risk, all children and adolescents should be screened for PIMU given now-normal heavy media usage rates. Effective treatment of PIMU starts with identification and management of comorbid mental and behavioral health problems. Depending on their degree of functional impairment, patients may benefit from various forms of psychotherapy with coordinated outpatient management or may warrant higher level of care in one of several established residential treatment programs. Few studies have evaluated pharmacologic approaches to treating PIMU, but some medications targeting comorbid mental and behavioral health conditions improve PIMU-related behaviors.
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Stavropoulos V, Adams BL, Beard CL, Dumble E, Trawley S, Gomez R, Pontes HM. Associations between attention deficit hyperactivity and internet gaming disorder symptoms: Is there consistency across types of symptoms, gender and countries? Addict Behav Rep 2019; 9:100158. [PMID: 30671530 PMCID: PMC6327637 DOI: 10.1016/j.abrep.2018.100158] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Videogame addiction has been suggested as a tentative disorder in 2013 by the American Psychiatric Association (APA) and was recently officially recognized as a mental health disorder by the World Health Organization (WHO). Although a few studies have identified attention deficit and hyperactivity disorder (ADHD) as a key risk factor for Internet Gaming Disorder (IGD), the interplay between ADHD and IGD symptoms with gender differences across cultures remains to be further examined. OBJECTIVE This study examined the moderating effects of gender in the association between ADHD and IGD across two nations. METHOD A cross-sectional online survey was developed to recruit 164 Australian (Mage = 23.01, SD = 3.35, Minage = 18, Maxage = 31, Males n = 121, 73.80%) and 457 U.S.-North American (Mage = 25.25 years, SD = 2.76, Minage = 18 years, Maxage = 29 years, Males = 265, 57.98%) Massively Multiplayer Online (MMO) players aged between 18 and 29 years. RESULTS The hierarchical linear regression, moderation and moderated moderation analyses revealed that participants presenting greater inattention and hyperactivity symptoms exhibited higher levels of IGD-related behaviors in the two samples. Moreover, these associations differed across genders between the two countries. Specifically, more hyperactive-impulsive, as well as inattentive males in the USA presented higher levels of disordered gaming. CONCLUSION The results highlight the need for more cross-cultural and symptom-focused research in the broader IGD field.
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Affiliation(s)
| | | | | | - Emma Dumble
- Cairnmillar Institute, Camberwell, Australia
| | | | | | - Halley M. Pontes
- Nottingham Trent University, Department of Psychology, International Gaming Research Unit, Nottingham, United Kingdom
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Łukawski K, Rusek M, Czuczwar SJ. Can pharmacotherapy play a role in treating internet addiction disorder? Expert Opin Pharmacother 2019; 20:1299-1301. [PMID: 31058549 DOI: 10.1080/14656566.2019.1612366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Krzysztof Łukawski
- a Department of Physiopathology , Institute of Rural Health , Lublin , Poland.,b Department of Pathophysiology , Medical University of Lublin , Lublin , Poland
| | - Marta Rusek
- b Department of Pathophysiology , Medical University of Lublin , Lublin , Poland.,c Department of Dermatology, Venereology and Pediatric Dermatology , Laboratory for Immunology of Skin Diseases, Medical University of Lublin , Lublin , Poland
| | - Stanisław J Czuczwar
- b Department of Pathophysiology , Medical University of Lublin , Lublin , Poland
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Sugaya N, Shirasaka T, Takahashi K, Kanda H. Bio-psychosocial factors of children and adolescents with internet gaming disorder: a systematic review. Biopsychosoc Med 2019; 13:3. [PMID: 30809270 PMCID: PMC6374886 DOI: 10.1186/s13030-019-0144-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/29/2019] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
- Nagisa Sugaya
- 1Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Tomohiro Shirasaka
- 2Department of Psychiatry, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-ku, Sapporo, Hokkaido 006-8555 Japan
| | - Kenzo Takahashi
- 3Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Hideyuki Kanda
- 4Faculty of Medicine, Department of Environmental Medicine and Public Health, Shimane University, 89-1 Enya-cho, Izumo-shi, Shimane 693-8501 Japan
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Gioia F, Boursier V. Treatment of Internet Addiction and Internet Gaming Disorder in Adolescence. ADVANCES IN PSYCHOLOGY, MENTAL HEALTH, AND BEHAVIORAL STUDIES 2019. [DOI: 10.4018/978-1-5225-8449-0.ch008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Internet use is growing year after year and adolescents represent a large proportion of internet users. There is a scholarly interest in teen internet gaming disorder (IGD) and internet addiction (IA) is constantly increasing, but little is known about the treatments of IA and IGD. This study systematically reviews the literature of the last fifteen years, focusing on two main aspects: adolescence, and IA and IGD intervention programs. The inclusion criteria were (1) contain empirical data, (2) include an analysis relating to IA or IGD, (3) include teen samples aged between 13 and 19 years or with an average age within this range, and (4) provide a full-text article published in English. A total number of 17 papers were included, 7 focused on IA and 10 focused on IGD. Prevalence and different treatment-related outcomes are discussed.
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47
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Lu WH, Chou WJ, Hsiao RC, Hu HF, Yen CF. Correlations of Internet Addiction Severity With Reinforcement Sensitivity and Frustration Intolerance in Adolescents With Attention-Deficit/Hyperactivity Disorder: The Moderating Effect of Medications. Front Psychiatry 2019; 10:268. [PMID: 31105605 PMCID: PMC6498759 DOI: 10.3389/fpsyt.2019.00268] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/08/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Deviations in reinforcement sensitivity and frustration-related reactions have been proposed as components of the biopsychosocial mechanisms, which explained the high vulnerability to internet addiction (IA) among individuals with attention-deficit/hyperactivity disorder (ADHD). There is currently limited knowledge on the relationship of IA symptoms with reinforcement sensitivity and frustration intolerance, as well as factors moderating those correlations in this population. Objective: The aims of this study were (1) to examine the associations of IA symptoms severity with reinforcement sensitivity and frustration intolerance and (2) identify the moderators of these associations among adolescents diagnosed with ADHD in Taiwan. Methods: A total of 300 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their levels of IA severity, reinforcement sensitivity, and frustration intolerance were assessed using the Chen Internet Addiction Scale, behavioral inhibition system (BIS) and behavioral approach system (BAS), and Frustration Discomfort Scale, respectively. The associations of IA severity with reinforcement sensitivity and frustration intolerance were examined using multiple regression analysis. Possible moderators, including medications for ADHD, were tested using the standard criteria. Results: Higher fun seeking on the BAS (p = .003) and higher frustration intolerance (p = .003) were associated with more severe IA symptoms. Receiving medication for treating ADHD moderated the association between fun seeking on the BAS and severity of IA symptoms. Conclusion: Fun seeking on the BAS and frustration intolerance should be considered as targets in prevention and intervention programs for IA among adolescents with ADHD.
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Affiliation(s)
- Wei-Hsin Lu
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center and College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States.,Department of Psychiatry, Children's Hospital and Regional Medical Center, Seattle, WA, United States
| | - Huei-Fan Hu
- Department of Psychiatry, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Kietglaiwansiri T, Chonchaiya W. Pattern of video game use in children with attention-deficit-hyperactivity disorder and typical development. Pediatr Int 2018; 60:523-528. [PMID: 29573063 DOI: 10.1111/ped.13564] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 01/15/2018] [Accepted: 03/09/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Video game playing is a favorite leisure activity among children worldwide. Individuals with attention-deficit-hyperactivity disorder (ADHD) often lack self-control, making them at risk for substance abuse and game addiction. There are conflicting results, however, between studies on the pattern of video gaming and game addiction between those with ADHD and healthy controls. We therefore compared the pattern of video game use and game addiction between Thai children with ADHD and healthy controls. METHODS A total of 80 participants with ADHD (median age, 9.5 years) and 102 controls (median age, 10 years) were recruited in this study. ADHD was diagnosed by a developmental pediatrician. Each control subject's teacher completed the ADHD questionnaire to ensure that they did not have the diagnosis of ADHD. Pattern of video game use and Game Addiction Screening Test (GAST) were completed by participants' parents. RESULTS More than half of the children with and without ADHD spent >2 h/day playing video games rather than engaging in other age-appropriate leisure activities, particularly on weekends. Participants with ADHD, however, had a higher rate of compulsive video game use than controls (37.5% vs 11.8%, P < 0.001). CONCLUSIONS Although video game playing was relatively prevalent in children regardless of ADHD status, those with ADHD had a higher rate of problematic video game use than controls. The pattern of leisure activities including video game use should be assessed during health supervision visits. As such, those at risk for game addiction could be identified early, resulting in appropriate intervention.
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Affiliation(s)
- Tanyawan Kietglaiwansiri
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Weerasak Chonchaiya
- Division of Growth and Development, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Maximizing Thai Children's Developmental Potential Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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Abstract
Should excessive and problematic engagement in nonsubstance use behaviors be mental disorders? The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) repositioned gambling disorder in the substance use disorders section and introduced Internet gaming disorder in the research appendix; the International Classification of Diseases (ICD-11) is also considering it. This article outlines pros and cons of considering behavioral addictions as mental disorders and also reviews the DSM-5 decision-making processes. It focuses on three conditions: gambling disorder, Internet gaming disorder (IGD), and Internet addiction (IA). We detail assessment methods and prevalence rates for these conditions and outline psychiatric comorbidities, demographic and biological risk factors, and promising treatment approaches. We also briefly discuss other putative behavioral addictions: eating/food, sex, exercise, shopping, and tanning "addictions." Overall, data are inconclusive, and consistent terminology and methodology are needed to define and evaluate these conditions more fully prior to considering them mental disorders.
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MESH Headings
- Behavior, Addictive/epidemiology
- Behavior, Addictive/etiology
- Behavior, Addictive/genetics
- Behavior, Addictive/therapy
- Disruptive, Impulse Control, and Conduct Disorders/epidemiology
- Disruptive, Impulse Control, and Conduct Disorders/etiology
- Disruptive, Impulse Control, and Conduct Disorders/genetics
- Disruptive, Impulse Control, and Conduct Disorders/therapy
- Gambling/epidemiology
- Gambling/etiology
- Gambling/genetics
- Gambling/therapy
- Humans
- Internet
- Video Games
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Affiliation(s)
- Nancy M Petry
- Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut 16032-3944, USA; , ,
| | - Kristyn Zajac
- Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut 16032-3944, USA; , ,
| | - Meredith K Ginley
- Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut 16032-3944, USA; , ,
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Marmet S, Studer J, Grazioli VS, Gmel G. Bidirectional Associations Between Self-Reported Gaming Disorder and Adult Attention Deficit Hyperactivity Disorder: Evidence From a Sample of Young Swiss Men. Front Psychiatry 2018; 9:649. [PMID: 30618855 PMCID: PMC6297670 DOI: 10.3389/fpsyt.2018.00649] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/16/2018] [Indexed: 01/07/2023] Open
Abstract
Background: Gaming disorder (GD) has been shown to co-occur with attention deficit hyperactivity disorder (ADHD), yet few studies to date have investigated their longitudinal associations. Method: The sample included 5,067 young Swiss men (mean age was 20 years at wave 1 and 25 years at wave 3). Measures were the Game Addiction Scale and the Adult ADHD Self-Report Scale (6-item screener). Longitudinal associations were tested using autoregressive cross-lagged models for binary measures of GD and ADHD, as well as continuous measures for GD score and ADHD subscales of inattention and hyperactivity. Results: ADHD at age 20 increased the risk for GD at age 25 (probit = 0.066 [0.023, 0.109]; p = 0.003). GD at age 20 also increased the risk for ADHD at wave 3 (probit = 0.058 [0.013, 0.102]; p = 0.011). Only the ADHD inattention subscale showed a bidirectional longitudinal relationship with the GD score (standardized Beta from inattention at age 20 to GD score at age 25: 0.090 [0.056, 0.124]; p < 0.001; from GD score at age 20 to inattention at age 25: 0.044 [0.016, 0.071]; p = 0.002), whereas associations between the hyperactivity subscale and GD were not significant. Discussion: GD had bidirectional longitudinal associations with ADHD, in that ADHD increased the risk for GD and GD increased the risk for ADHD, and they may reinforce each other. These associations may be linked more to the inattention ADHD component than to the hyperactivity ADHD component. Individuals with ADHD or GD should be screened for the other disorder, and preventive measures for GD should be evaluated in individuals with ADHD.
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Affiliation(s)
- Simon Marmet
- Alcohol Treatment Centre, Lausanne University Hospital/CHUV, Lausanne, Switzerland
| | - Joseph Studer
- Alcohol Treatment Centre, Lausanne University Hospital/CHUV, Lausanne, Switzerland
| | - Véronique S Grazioli
- Alcohol Treatment Centre, Lausanne University Hospital/CHUV, Lausanne, Switzerland
| | - Gerhard Gmel
- Alcohol Treatment Centre, Lausanne University Hospital/CHUV, Lausanne, Switzerland.,Addiction Switzerland, Lausanne, Switzerland.,Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Health and Social Sciences, University of the West of England, Frenchay, Bristol, United Kingdom
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