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Koncz P, Demetrovics Z, Takacs ZK, Griffiths MD, Nagy T, Király O. The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis. Clin Psychol Rev 2023; 106:102343. [PMID: 37883910 DOI: 10.1016/j.cpr.2023.102343] [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: 09/27/2022] [Revised: 06/27/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.
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Affiliation(s)
- Patrik Koncz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar.
| | - Zsofia K Takacs
- School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Chang RS, Lee M, Im JJ, Choi KH, Kim J, Chey J, Shin SH, Ahn WY. Biopsychosocial factors of gaming disorder: a systematic review employing screening tools with well-defined psychometric properties. Front Psychiatry 2023; 14:1200230. [PMID: 37533885 PMCID: PMC10390702 DOI: 10.3389/fpsyt.2023.1200230] [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: 04/04/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Background and aims Considering the growing number of gamers worldwide and increasing public concerns regarding the negative consequences of problematic gaming, the aim of the present systematic review was to provide a comprehensive overview of gaming disorder (GD) by identifying empirical studies that investigate biological, psychological, and social factors of GD using screening tools with well-defined psychometric properties. Materials and methods A systematic literature search was conducted through PsycINFO, PubMed, RISS, and KISS, and papers published up to January 2022 were included. Studies were screened based on the GD diagnostic tool usage, and only five scales with well-established psychometric properties were included. A total of 93 studies were included in the synthesis, and the results were classified into three groups based on biological, psychological, and social factors. Results Biological factors (n = 8) included reward, self-concept, brain structure, and functional connectivity. Psychological factors (n = 67) included psychiatric symptoms, psychological health, emotion regulation, personality traits, and other dimensions. Social factors (n = 29) included family, social interaction, culture, school, and social support. Discussion When the excess amount of assessment tools with varying psychometric properties were controlled for, mixed results were observed with regards to impulsivity, social relations, and family-related factors, and some domains suffered from a lack of study results to confirm any relevant patterns. Conclusion More longitudinal and neurobiological studies, consensus on a diagnostic tool with well-defined psychometric properties, and an in-depth understanding of gaming-related factors should be established to settle the debate regarding psychometric weaknesses of the current diagnostic system and for GD to gain greater legitimacy in the field of behavioral addiction.
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Affiliation(s)
- Rose Seoyoung Chang
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Minju Lee
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Jooyeon Jamie Im
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Jueun Kim
- Department of Psychology, Chungnam National University, Daejeon, Republic of Korea
| | - Jeanyung Chey
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Suk-Ho Shin
- Department of Child and Adolescent Psychiatry, Dr. Shin’s Neuropsychiatric Clinic, Seoul, Republic of Korea
| | - Woo-Young Ahn
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
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Vally Z. Anger and worry are related to problematic smartphone use: A cross-sectional examination of novel psychopathological constructs in a college-aged sample in the United Arab Emirates. Heliyon 2022; 8:e10917. [PMID: 36217486 PMCID: PMC9547193 DOI: 10.1016/j.heliyon.2022.e10917] [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] [Received: 12/07/2021] [Revised: 02/23/2022] [Accepted: 09/28/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Problematic smartphone use (PSU) has consistently been shown to be associated with depression and anxiety. However, the association of PSU and psychological constructs beyond these two have rarely been subjected to examination. Worry and anger are transdiagnostic constructs that, given their conceptual similarity with depression and anxiety, may similarly evidence significant relationships with PSU. Methods To test these hypotheses, a sample of 264 college-aged students were recruited from a university in the United Arab Emirates. The sample ranged in age from 18 to 36 years (M = 21.51, SD = 2.99). Self-report measures of PSU, worry and anger were administered. Results Results revealed statistically significant associations with PSU, anger, and worry – these results were evident following correlational as well as regression analyses. Moreover, using a recommended cut-off score from the literature to identify participants scoring beyond the clinical threshold indicative of PSU, worry and anger scores were significantly higher in the clinical sub-group. Conclusions This study's results lend additional credibility to uses and gratifications theory and compensatory internet use theory as it appears that the excessive use of technologies may indeed serve the purpose of compensating for the management of emotional distress. Results are discussed within the context of these two theories.
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Affiliation(s)
- Zahir Vally
- Department of Clinical Psychology, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Wolfson College, University of Oxford, Oxford, United Kingdom
- Corresponding author.
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Sex differences in ADHD symptoms, problematic gaming, and impairment in college students. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03469-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Khazaal Y, El Abiddine FZ, Penzenstadler L, Berbiche D, Bteich G, Valizadeh-Haghi S, Rochat L, Achab S, Khan R, Chatton A. Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12099. [PMID: 36231401 PMCID: PMC9566183 DOI: 10.3390/ijerph191912099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy. METHODS We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants. RESULTS Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use. CONCLUSIONS Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.
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Affiliation(s)
- Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, 1015 Lausanne, Switzerland
- Department of Psychiatry and Addictology, Montréal University, Montréal, QC H3T 1J4, Canada
| | - Fares Zine El Abiddine
- Laboratory Psychological and Educational Research, Department of Psychology, University Djillali Liabes of Sidi Bel Abbes, Sidi Bel Abbes 22000, Algeria
| | - Louise Penzenstadler
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Djamal Berbiche
- Charles-LeMoyne Hospital Research Centre, Sherbrooke University, Sherbrooke, QC J1K 2R1, Canada
| | - Ghada Bteich
- Faculty of Public Health, Lebanon University, Tripoli P.O. Box 6573/14, Lebanon
| | - Saeideh Valizadeh-Haghi
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lucien Rochat
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Sophia Achab
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Riaz Khan
- Department of Mental Health and Psychiatry, Frontier Medical College Affiliated to Bahria University Islamabad, Abbottabad 22010, Pakistan
| | - Anne Chatton
- Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
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André F, Munck I, Håkansson A, Claesdotter-Knutsson E. Game Addiction Scale for Adolescents-Psychometric Analyses of Gaming Behavior, Gender Differences and ADHD. Front Psychiatry 2022; 13:791254. [PMID: 35356720 PMCID: PMC8959768 DOI: 10.3389/fpsyt.2022.791254] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/31/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Internet gaming disorder (IGD) was recently added in the Diagnostic and Statistical Manual of Mental Disorder as a "condition for further studies." There is no consensus regarding which rating scales should be used but many scholars suggest the GASA (Game Addiction Scale for Adolescents) and a ranking of the criteria, "the core approach" to avoid over-diagnosing of disordered gaming. Male gender and ADHD are commonly listed as risk factors for disordered gaming but little is known about sex differences in gaming and gender specific health correlates. PURPOSE The present study aims to evaluate the core approach and the specific indicators of gaming behavior in GASA from a multifactorial perspective and explore the gender differences in a clinical setting, focusing on ADHD. PATIENTS AND METHODS Children and adolescents aged 8-18 years (n = 144) from Child and adolescent psychiatry (CAP) in Skane were assessed with the GASA. Psychometric analyses including confirmatory factor analyses (CFA) and structural equation modeling (SEM) were used to identify well-defined constructs and gender differences. Refined factor scores for single constructs were the outcome of alignment, a procedure for assessing measurement equivalence across gender. New model-based gaming behavior variables were used for descriptive statistics and ANOVA testing of gender differences. RESULTS The results confirm that the core approach two-factor model is valid for the CAP sample, as well as a theory based psycho-social model for gaming behavior with over consumption and negative social and emotional consequences. Our findings suggest that negative consequences of over consumption take a social direction for boys and an emotional direction for girls. Also, ADHD was significantly associated with over consumption of video games and the negative consequences thereof for girls. CONCLUSION Guided by psychometric analyses, the GASA could be strengthened by advancing the questionnaire design and by adding complementary items in order to illuminate the complexity of gaming behavior. Our findings suggest that additional research on potential gender related discrepancies of disordered gaming is needed.
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Affiliation(s)
- Frida André
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ingrid Munck
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden
| | - Anders Håkansson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.,Gambling Disorder Unit, Malmö Addiction Centre, Malmö, Sweden
| | - Emma Claesdotter-Knutsson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.,Child and Adolescent Psychiatry, Regional Out-Patient Care, Lund University Hospital, Region Skåne, Lund, Sweden
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Chen C, Dai S, Shi L, Shen Y, Ou J. Associations Between Attention Deficit/Hyperactivity Disorder and Internet Gaming Disorder Symptoms Mediated by Depressive Symptoms and Hopelessness Among College Students. Neuropsychiatr Dis Treat 2021; 17:2775-2782. [PMID: 34465993 PMCID: PMC8403024 DOI: 10.2147/ndt.s325323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/12/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The mediating role of depressive symptoms and hopelessness on the relationship between attention deficit/hyperactivity disorder (ADHD) and internet gaming disorder (IGD) symptoms has not yet been elucidated. This study assessed this mediating effect in college students. PARTICIPANTS AND METHODS Participants consisted of 1236 freshmen recruited at a local university. Symptoms of ADHD, IGD, depression and hopelessness were measured using self-report scales. The effect of ADHD on IGD mediated by depression and hopelessness was analyzed by Haye's PROCESS macro for SPSS (Model 6) using the bias-corrected percentile bootstrap method with 5000 bootstrapped samples. RESULTS Symptoms of ADHD, depression and hopelessness were common in college students and were strongly associated with the appearance of IGD symptoms. ADHD symptoms of college students impacted their IGD symptoms directly and indirectly via depressive symptoms and hopelessness. The total effect of ADHD symptoms on IGD symptoms was 0.075 (standard error [SE]: 0.009, 95% confidence interval [CI] 0.057, 0.093), with a direct effect of 0.037 (SE: 0.010, 95% CI 0.018, 0.056, effect ratio: 49.3%), and total indirect effect was 0.038 (SE: 0.005, 95% CI 0.029, 0.050, effect ratio: 50.7%). CONCLUSION Depressive symptoms and hopelessness can mediate the relationship between ADHD and IGD symptoms among college students. These findings point to the importance of evaluating ADHD, depressive and hopelessness symptoms for the prevention and treatment of adult IGD.
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Affiliation(s)
- Chen Chen
- Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai, Shanghai, People's Republic of China.,Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Si Dai
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Lijuan Shi
- School of Education, Hunan University of Science and Technology, Xiangtan, Hunan, People's Republic of China
| | - Yidong Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
| | - Jianjun Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China
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