Validation of the Internet Gaming Disorder Symptoms Checklist Based on the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders in Chinese Adolescents

Prevalence of internet gaming disorder among Chinese adolescents: A systematic review and meta-analysis

This study aimed to evaluate the prevalence of IGD among Chinese adolescents. Articles published up to April 11, 2024 were retrieved from PubMed, Wiley Online Library, Embase, Web of Science, Ebsco, CNKI, and WanFang. Random-effects models and univariate meta-regression analyses were used to calculate prevalence and heterogeneity estimates with the support of Stata17.0 software. The prevalence of IGD in Chinese adolescents was 10 % (95 %CI: 8 %-12 %). Univariate regression analyses revealed some significant moderators of IGD prevalence, including gender, sample size, and survey year. Spatiotemporal analysis showed the prevalence of IGD varied considerably across provinces in different survey years.

Association Between Internet Gaming Disorder and Suicidal Ideation Mediated by Psychosocial Resources and Psychosocial Problems Among Adolescent Internet Gamers in China: Cross-Sectional Study

BACKGROUND

Adolescent internet gaming disorder (IGD) was associated with severe harm, including suicidal ideation. While suicidal ideation was predictive of completed suicides, further research is required to clarify the association between IGD and suicidal ideation among adolescents, as well as the mechanisms involved.

OBJECTIVE

This study aimed to investigate the understudied association between IGD and suicidal ideation, as well as novel mechanisms associated with it, among Chinese adolescent internet gamers through psychosocial coping resources and psychosocial problems.

METHODS

An anonymous, self-administered, cross-sectional survey was conducted among secondary school students who had played internet games in the past year in Guangzhou and Chengdu, China (from October 2019 to January 2020). In total, 1693 adolescent internet gamers were included in this study; the mean age was 13.48 (SD 0.80) years, and 60% (n=1016) were males. IGD was assessed by the 9-item Internet Gaming Disorder Checklist of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]), while a single item assessed suicidal ideation: "Have you ever considered committing suicide in the past 12 months?" Univariate and multivariate logistic regression associations were conducted to test the significance and directions of the potential factors for suicidal ideation. The mediation mechanism was examined by structural equation modeling.

RESULTS

Among all participants, the prevalence of IGD and suicidal ideation was 16.95% (287/1693) and 43.06% (729/1693), respectively. IGD cases were 2.42 times more likely than non-IGD cases to report suicidal ideation (adjusted odds ratio [OR] 2.42, 95% CI 1.73-3.37). Other significant factors of suicidal ideation included psychosocial coping resources (resilience and social support, both adjusted OR 0.97, 95% CI 0.96-0.98) and psychosocial problems (social anxiety: adjusted OR 1.07, 95% CI 1.05-1.09; loneliness, adjusted OR 1.13, 95% CI 1.10-1.16). The association between IGD and suicidal ideation was partially mediated by 3 indirect paths, including (1) the 2-step path that IGD reduced psychosocial coping resources, which in turn increased suicidal ideation; (2) the 2-step path that IGD increased psychosocial problems, which in turn increased suicidal ideation; and (3) the 3-step path that IGD reduced psychosocial coping resources which then increased psychosocial problems, which in turn increased suicidal ideation, with effect sizes of 10.7% (indirect effect/total effect: 0.016/0.15), 30.0% (0.05/0.15), and 13.3% (0.02/0.15), respectively. The direct path remained statistically significant.

CONCLUSIONS

IGD and suicidal ideation were alarmingly prevalent. Evidently and importantly, IGD was a significant risk factor for suicidal ideation. The association was partially explained by psychosocial coping resources of resilience and social support and psychosocial problems of social anxiety and loneliness. Longitudinal studies are needed to confirm the findings. Pilot randomized controlled trials are recommended to evaluate the effectiveness of interventions in reducing suicidal ideation by reducing IGD, improving psychosocial coping resources, and reducing psychosocial problems investigated in this study.

Development and validation of the resource loss due to reduction in gaming time scale among adolescent internet gamers in China

BACKGROUND

Adolescent internet gaming disorder (IGD) is prevalent and positively associated with gaming time, a reduction of which is a common means of IGD prevention/treatment. Personal/interpersonal resource losses due to the reduction in gaming time (RL-RGT) are plausible. According to the Conservation of Resource (COR) theory, RL-RGT may cause mental distress and maladaptive behaviors. No study has investigated such relationships, partially due to the lack of validated tools assessing RL-RGT. This study aimed to develop and validate such a scale (RL-RGTS).

METHODS

A cross-sectional survey was conducted in four secondary schools in Guangzhou, China (October to December 2019). Secondary school students who had played internet games in the last 12 months participated in this study (n = 944), irrespective of their IGD status and intention to reduce gaming time. Using a deductive approach, an expert panel generated the 19 scale items. The half-split method was used to conduct exploratory and confirmatory factor analyses.

RESULTS

The prevalence of IGD and intention to reduce gaming time were 10.9% and 74.2%, respectively. The exploratory and confirmatory factor analyses identified a 2-factor model (personal loss and interpersonal loss). Psychometric properties (internal consistency, no ceiling effect, and concurrent validity) were satisfactory, but noticeable floor effects were observed.

CONCLUSIONS

The RL-RGTS could be applied to understand potential side effects and obstacles regarding interventions reducing IGD through reducing gaming time. The findings support the COR theory and extend its applications to internet gaming research. Validations in other populations are warranted.

Relationships Between Job Stress, Psychological Adaptation and Internet Gaming Disorder Among Migrant Factory Workers in China: The Mediation Role of Negative Affective States

Factory workers make up a large proportion of China's internal migrants and may be highly susceptible to job and adaptation stress, negative affective states (e.g., depression and anxiety), and Internet gaming disorder (IGD). This cross-sectional study investigated the relationships between job stress, psychological adaptation, negative affective states and IGD among 1,805 factory workers recruited by stratified multi-stage sampling between October and December 2019. Structural equation modeling (SEM) was conducted to test the proposed mediation model. Among the participants, 67.3% were male and 71.7% were aged 35 years old or below. The prevalence of probable depression, probable anxiety, and IGD was 39.3, 28.7, and 7.5%. Being male, younger age, and shorter duration of living in Shenzhen were associated with higher IGD scores. Job stress was significantly associated with IGD (β = 0.11, p = 0.01) but not with negative affective states (β = 0.01, p = 0.77). Psychological adaptation was significantly associated with negative affective states (β = -0.37, p < 0.001) but not with IGD (β = 0.09, p > 0.05). Negative affective states were positively associated with IGD (β = 0.27, p < 0.001). The indirect effect of psychological adaptation (β = -0.10, p = 0.004) but not job stress (β = 0.003, p = 0.77) on IGD through negative affective states was statistically significant. The observed psychological correlates and mechanisms are modifiable, and can inform the design of evidence-based prevention programs for depression, anxiety, and IGD in this population.

Symptoms of internet gaming disorder among male college students in Nanchong, China

BACKGROUND

This study aimed to evaluate the presence of symptoms of Internet Gaming Disorder (IGD) and examined associations between IGD and depressive symptoms, family and peer support among male college students in Nanchong, China.

METHODS

A cross-sectional study was conducted among 2533 male students in three colleges. Background characteristics, depressive symptoms, family and peer support and IGD information were collected. Binary logistic regression was performed to access the relationship between variables and IGD. PROCESS macro was used to examine the mediation analysis of family and peer support on the relationship between depressive symptoms and IGD.

RESULTS

The estimated presence of symptoms of IGD was 11.6%. The most commonly endorsed items were escapism, continuation and preoccupation both among total participates and the IGD group. In the binary logistic regression, general expenditure per month, depressive symptoms, and family and peer support revealed their significance in associations with IGD. Adjusted for the significant background variable, depressive symptoms and family and peer support remained significance. Additionally, family and peer support would attenuate the relationship between depressive symptoms and IGD.

CONCLUSIONS

This study found that one in ten male college students reported clinically significant IGD symptoms, which indicate that IGD is an important public health problem in Nanchong, China.

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

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